Social anxiety disorder.

As defined in the DSM-IV-TR (1), social anxiety disorder (SAD), or social phobia, is now well recognized as a prevalent and significantly impairing disorder with an onset early in life. Since Liebowitz and colleagues’ commentary regarding the neglect of SAD in the contemporary literature (2), there has been considerable research into the nature of SAD, its natural history, its biological and environmental underpinnings, and its treatment. There has also been concern about the pathologizing of normal temperamental variations. This concern is most commonly linked to the use of pharmacologic treatments, particularly in younger patients, and has been exacerbated by the debate about the safety of antidepressant treatment of children and adolescents (3).