EpistemisSocial avoidance
Specialty: Psychiatry.
Why it occurs
- Social anxiety disorder (social phobia)
- Avoidant personality disorder
- Autism spectrum disorder (ASD, due to sensory overload or social misunderstanding)
- Major depressive disorder
- Schizophrenia (negative symptom of asociality)
- Body dysmorphic disorder (avoidance due to shame of one's own appearance)
Initial workup
Liebowitz Social Anxiety Scale (LSAS); ADOS-2 or ADI-R scale if underlying ASD is suspected; psychosocial assessment of the patient's environment.
red flags
Absolute home isolation lasting months (Hikikomori syndrome), malnutrition due to neglect, extreme hygienic neglect and total abandonment of medical treatments for stable chronic pathologies.
Standard management
- Paroxetine or Sertraline — SSRI with specific indication and high efficacy in social phobia
- Venlafaxine — Dual inhibitor, useful in cases with a depressive or marked avoidance component
- Propranolol — beta blocker used occasionally 30-60 minutes before specific social exposures to control physical symptoms such as tremor, sweating and tachycardia
- Pregabalin — calcium channel modulator, as an adjuvant in refractory social anxiety
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Psychiatry
- Listed causes
- 6
- Treatment options
- 4