Her mother brings a 16-year-old girl to the office with vague stomachaches and pains. She has no previous medical history. Since the start of the school year six months ago, the patient has missed more than ten days of class owing to symptoms. According to the mother, her daughter has always been worried and has a "sensitive stomach," but the symptoms have gotten worse since the patient's best friend moved away a month ago. She has a few more pals, but she likes to stay at home and avoids after-school events. "She worried for weeks about going to a party," the mother adds. She suffered an anxiety attack and began hyperventilating the night before the party. She ended up not going to the party at all." The patient says she is "just very shy" and is afraid of being embarrassed or "looking stupid" around others. Physical examination shows no abnormalities. During the interview, the patient makes little eye contact and gives brief answers to questions. Which of the following is the most likely diagnosis?

Question

Her mother brings a 16-year-old girl to the office with vague stomachaches and pains. She has no previous medical history. Since the start of the school year six months ago, the patient has missed more than ten days of class owing to symptoms. According to the mother, her daughter has always been worried and has a "sensitive stomach," but the symptoms have gotten worse since the patient's best friend moved away a month ago. She has a few more pals, but she likes to stay at home and avoids after-school events. "She worried for weeks about going to a party," the mother adds. She suffered an anxiety attack and began hyperventilating the night before the party. She ended up not going to the party at all."  The patient says she is "just very shy" and is afraid of being embarrassed or "looking stupid" around others.  Physical examination shows no abnormalities.  During the interview, the patient makes little eye contact and gives brief answers to questions.  Which of the following is the most likely diagnosis?

Quizplus · Accepted Answer

Eductional Objective: This patient's severe social anxiety, in which she dread public humiliation and scrutiny, is typical of social anxiety disorder (social phobia). It is a common mental condition that usually manifests itself in adolescence and can cause severe impairment in functioning and quality of life. Significant discomfort is caused by social contacts with peers and meeting new individuals. Anticipatory anxiety weeks before a social function is typical, as is avoidance (not attending to parties, school refusal).
Patients with social anxiety disorder usually look agitated during interviews, avoid eye contact, provide excessively short replies, and may display physical symptoms of anxiousness (eg, blushing, sweating, trembling, tachycardia). Patients who experience symptoms exclusively in performance conditions are assigned the specifier "performance-only" (eg, speaking or performing in public)

Her Mother Brings a 16-Year-Old Girl to the Office with Vague