Social anxiety disorder in older adults: Evidence from the National Epidemiologic Survey on alcohol and related conditions

Objective: This study aims to investigate the following: 1) the association of social anxiety disorder with childhood parental loss and recent stressful life events; 2) the coexistence of social anxiety disorder and major depressive disorders (MDD): and 3) the impact of social anxiety disorder on medical conditions, obesity, health service utilization, and health-related quality of life. Design: Cross-sectional observational study. Setting: The National Epidemiologic Survey on Alcohol and Related Conditions (2001-2002), a national representative survey of the U.S. noninstitutionalized household population. Participants: 13,420 respondents aged 55 and above. Measurements: Social anxiety disorder was assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version (AUDADIS-IV). Demographic characteristics, psychosocial risk factors, psychiatric disorders, health-related quality of life, obesity, medical conditions, and health service utilization were measured. Results: The current and lifetime prevalence rates of specific phobia were found to be 1.83% and 3.50%, respectively. Multivariate analyses revealed that social anxiety disorder was more common among the younger age groups and those who reported stressful life events. In addition, MDD, specific phobia, and personality disorder were significantly related to social anxiety disorder. Lastly, after adjusting for other psychiatric comorbidities, the association of social anxiety disorder with health-related quality of life. medical condition, and health care service utilization became insignificant. Conclusion: The correlation between social anxiety disorder and MDD raises further questions about the nature of social anxiety disorder among older adults, but this study does not support the notion that this disorder has a strong impact on the quality of life in old age independent of other psychiatric comorbidities. (C) 2009 Elsevier B.V. All rights reserved.