Clinical differences between early- and late-onset social anxiety disorders


  • Juwon Ha and Se-Won Lim contributed equally to this work.

Professor Kang-Seob Oh, Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung-dong, Jongro-Gu, Seoul, 110-746, Korea. Email:


Aim: The aim of this study was to elucidate the clinical differences between early- and late-onset social anxiety disorder (SAD) in the Korean population.

Methods: Three hundred and eighty-seven outpatients diagnosed with SAD participated in this study. Confirmation of SAD diagnosis was based on the Mini International Neuropsychiatric Interview. All subjects completed the Liebowitz Social Anxiety Scale and anxiety-trait-related scales such as the Anxiety Sensitivity Index, Retrospective Self-Report of Inhibition, Trait Form of the State-Trait Anxiety Inventory, and Beck Depression Inventory.

Results: The early-onset group (n = 209) consisted of subjects aged up to 18 years at the time of onset, whereas the late-onset group (n = 178) consisted of subjects older than 18 years at the time of onset. Early-onset SAD patients were more likely to have the generalized subtype and to visit clinics with chief complaints other than social anxiety symptoms. They exhibited more severe symptoms and higher behavioural inhibitions. After adjusting for age and symptom severity, behavioural inhibition was the only significant difference between the two groups. The degree of behavioural inhibitions was associated with earlier onset age.

Conclusion: Symptom severity and behavioural inhibitions, especially in social/school situations, were clinical characteristics that differentiated between early- and late-onset SAD.