Under the current guidelines of the Diagnosis and Statistical Manual of Mental Disorders, DSM-IV, individuals with an existing medical condition who also suffer from anxiety should not be diagnosed for social anxiety disorder (SAD) if their anxiety is related to their medical condition. However, recent research has been indicating that individuals with such medical conditions as stuttering and Parkinson’s Disease can actually experience SAD caused by their condition if their anxiety is considered to be excessive. Most research has focused on these two aforementioned conditions in terms of SAD diagnoses, yet the same comparison has not been made for individuals with obesity.
In a new study, researchers at the Rhode Island Hospital and Brown University’s Psychiatry and Human Behavior department compared the clinical characteristics and demographics of 791 individuals seeking psychiatric clearance for bariatric surgery. For their evaluation, all participants were also required to complete a comprehensive diagnostic interview, which researchers used to rate participants’ existing levels for and histories of anxiety. Led by Kristy L. Dalrymple Ph.D., the research team placed the participants into three groups: one group of obese individuals who qualified for clinical DSM-IV SAD diagnosis (135 participants); one group of individuals who qualified for ‘modified’ SAD diagnosis, in which the individual’s social anxiety was significantly related to their weight only (40 participants); and another group of obese individuals who did not have a history of psychiatric conditions (616 participants).
In their results, researchers found that the two social anxiety groups shared similar characteristics regarding their social impairment that noticeably differed from the non- disorder group. Both the SAD group and the modified SAD group had similarly poor levels of social functioning impairment during their adolescence, within the past 5 years, and current overall functioning—levels that measured significantly worse than that of the non-disorder group. Compared to the other two groups, the clinical SAD group reported higher rates of distress caused by their emotional or psychiatric state that impacted their ability to work.
However, even though the modified SAD group reported later onset of their anxiety than the clinical SAD group, these individuals had the highest rate of disruption to their social lives. Interestingly, these individuals’ anxiety within the past six months—although their anxiety was related directly to their weight—caused them to experience greater disruption to their social lives and more distress concerning their condition than the clinical SAD group. This finding, according to the researchers, indicates that obese individuals with weight-related anxiety can experience significant psychiatric impairment, perhaps due to the fact that their weight changes are more recent than those who have dealt with social anxiety over longer periods of time, and therefore are undergoing greater changes to their social lifestyles.
The proposed draft for the upcoming edition of the manual—DSM-5—created by the Anxiety Disorder Workgroup, suggests incorporating the diagnosis of SAD in individuals with existing medical conditions and excessive anxiety. Because obese individuals with significant anxiety related to their weight showed such high levels of distress that compared to clinical diagnosis, the researchers of the current study suggest that such an inclusion in the criteria for SAD would be justified. Their study has been published in the recent issue of the scientific journal Depression and Anxiety.
Source: MedNews Today, Weight Alone Can Cause Obese Individuals To Suffer From Social Anxiety Disorder, April 14, 2011