Here are the diagnostic criteria for Social Anxiety Disorder from both sides of the Atlantic. US definition   European definition The first description comes from the DSM-IV, the fourth version (issued in 1994) of the Diagnostic and Statistical Manual, the standard reference work issued by the American Psychiatrists Association.

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The second description is taken from the World Health Organisation's ICD-10 Classification of Mental and Behavioral Disorders, which came out in 1992. Diagnostic Criteria - A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing. Note: In children, there must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults. - Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed Panic Attack. Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or shrinking from social situations with unfamiliar people. - The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent. - The feared social or performance situations are avoided or else are endured with intense anxiety or distress. - The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia. - In individuals under age 18 years, the duration is at least 6 months. - The fear or avoidance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition and is not better accounted for by another mental disorder (e.g., Panic Disorder With or Without Agoraphobia, Separation Anxiety Disorder, Body Dysmorphic Disorder, a Pervasive Developmental Disorder, or Schizoid Personality Disorder). - If a general medical condition or another mental disorder is present, the fear in Criterion A is unrelated to it, e.g., the fear is not of Stuttering, trembling in Parkinson's disease, or exhibiting abnormal eating behavior in Anorexia Nervosa or Bulimia Nervosa. Specify if: Generalized: if the fears include most social situations (also consider the additional diagnosis of Avoidant Personality Disorder). Associated Features: Depressed Mood Somatic/Sexual Dysfunction Addiction Anxious/Fearful/Dependent Personality Differential Diagnosis: Panic Disorder With Agoraphobia; Agoraphobia Without History of Panic Disorder; Separation Anxiety Disorder; Generalized Anxiety Disorder; Specific Phobia; Pervasive Developmental Disorder; Schizoid Personality Disorder; Avoidant Personality Disorder; associated features of many other mental disorders; Anxiety Disorder Not Otherwise Specified; Performance anxiety, stage fright, and shyness. Diagnostic and Statistical Manual, Fourth Version, 1994 © American Psychiatrists Association Social phobias often start in adolescence and are centred around a fear of scrutiny by other people in comparatively small groups (as opposed to crowds), leading to avoidance of social situations. Unlike most other phobias, social phobias are equally common in men and women. They may be discrete (ie- restricted to eating in public, to public speaking, or to encounters with the opposite sex) or diffuse, involving almost all social situations outside the family circle. A fear of vomiting in public may be important. Direct eye-to-eye confrontation may be particularly stressful in some cultures. Social phobias are usually associated with low self-esteem and fear of criticism. They may present as a complaint of flushing, hand tremor, nausea, or urgency of micturition, the individual sometimes being convinced that one of these secondary manifestations of anxiety is the primary problem; symptoms may progress to panic attacks. Avoidance is often marked, and in extreme cases may result in almost complete social isolation. Diagnostic Guidelines All of the following criteria should be fulfilled for a definite diagnosis: (a) the psychological, behavioural, or autonomic symptoms must be primarily manifestations of anxiety and not secondary to other symptoms such as delusions or obsessional thoughts; (b) the anxiety must be restricted to or predominate in particular social situations; and (c) avoidance of the phobic situations must be a prominent feature. Includes: - anthropophobia - social neurosis Differential Diagnosis Agoraphobia and depressive disorders are often prominent, and may both contribute to sufferers becoming "housebound". If the distinction between social phobia and agoraphobia is very difficult, precedence should be given to agoraphobia; a depressive diagnosis should not be made unless a full depressive syndrome can be identified clearly. The ICD-10 Classification of Mental and Behavioural Disorders World Health Organization, Geneva, 1992 - © 1992 by World Health Organization.

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