The National Institute for Health and Clinical Excellence (NICE) has launched its first clinical guideline on social anxiety disorder, emphasising the importance of a prompt diagnosis in ensuring people access the most clinically and cost effective treatment.
Social anxiety disorder is one of the most common anxiety disorders, affecting about 1 in 10 people. It involves the persistent fear of certain social situations, such as meeting new people, talking in meetings, eating or drinking while being observed, and public performances such as speaking to a group. People with social anxiety disorder worry about these situations excessively, and so try to avoid them. This can have a large impact on their personal and work lives and their education.
While a range of effective psychological and pharmacological treatments exist for the disorder, many may not access them, and only half seek treatment, according to NICE. This is partly because the disorder is under-recognised and inadequately assessed, especially in primary care.
To combat this, NICE has developed the clinical guideline, which includes recommendations to help healthcare professionals with diagnosis and the provision of follow-up care.
Due to the nature of the social anxiety disorder, visiting services for treatment can cause difficulties for people with the condition. As a result, NICE recommends that services provide clear information to a person with social anxiety disorder on where they should go on arrival and where they can wait, when first getting in contact with them.
Information should include the location of facilities at the service, such as the car park and toilets, and what will not happen during assessment and treatment.
To identify adults with possible social anxiety disorder, healthcare professionals should ask questions in line with the NICE clinical guideline on common mental health disorders.
Range of treatment options
NICE also recommends a range of treatment options for adults with social anxiety disorder. This includes cognitive behavioural therapy (CBT) that has been specifically developed to treat social anxiety disorder.
Adults who decline CBT and wish to consider another psychological intervention should be offered CBT-based supported help.
However, those adults who prefer a pharmacological intervention should discuss their reasons for declining cognitive behavioural interventions and address any concerns.
Professor Mark Baker, director of the Centre for Clinical Practice at NICE, said: “Social anxiety disorder isn't about being shy at parties or feeling anxious about a job interview, it's about experiencing a level of anxiety that can disrupt normal life, interfering with social relationships and affecting performance at work or school. In these cases, it is really important that the individual is able to get the right help.
“This guideline includes a number of recommendations to support healthcare professionals to accurately diagnose and manage social anxiety disorder. We hope that the development of NICE guidance in this area will help ensure that those affected by this disorder receive the best possible support.”
Nicky Lidbetter, chief executive of Anxiety UK, welcomed the development of the guideline and the recognition that the condition can be extremely disabling for those who experience it.
“The recommendations for the treatment of social anxiety disorder will provide GPs and other health professionals with a clear pathway to provide the help and support needed,” she said.