Diagnostik der sozialen Phobie

Zusammenfassung

Obwohl soziale Phobien eine der häufigsten psychiatrischen Störungen sind, bleiben sie in der Praxis häufig unerkannt. Insbesondere die Abgrenzung von subklinischen Ängsten und die differenzialdiagnostische Einordnung gegenüber anderen Angststörungen, depressiven Störungen und der vermeidend-selbstunsicheren Persönlichkeitsstörung gestalten sich oft als schwierig. Im Vergleich zu den strukturierten diagnostischen Interviews zur Erfassung sozialer Phobie, die zeitaufwendig sind und einem psychiatrisch-psychotherapeutisch geschulten Personal vorbehalten bleiben, erweisen sich die in den letzten Jahren entwickelten psychometrischen Testverfahren als in der Praxis schnell und einfach durchführbar, zugleich jedoch hoch sensitiv und spezifisch. Insbesondere die Skala „Social Phobia Inventory” (SPIN) und deren Kurzform Mini-SPIN, die mit ihren 17 bzw. drei Items in nur wenigen Minuten durchführbar sind, erlauben eine korrekte Identifikation von fast 90% aller Patienten mit sozialer Phobie. Der Einsatz dieser und ähnlicher standardisierter Skalen in der haus- und nervenärztlichen Praxis zum Screening nach sozialer Phobie kann dazu beitragen, Erkrankungen häufiger und früher zu diagnostizieren, eine spezifische Behandlung einzuleiten und somit den häufigen Komorbiditäten und der Chronifizierung der Symptomatik entgegenzuwirken.

Summary

Even though social phobia is one of the most common psychiatric disorders, it frequently remains unrecognized in practice. Discrimination from subclinical anxiety and differential diagnoses such as other anxiety disorders, depressive and anxious personality disorder appears difficult. Over the last years several psychometric screening devices have been developed, which turned out to be quickly and easily accomplishable as well as highly sensitive and specific, as compared to structured diagnostic interviews, which themselves are relatively time-consuming and only applicable by skilled psychiatric or psychotherapeutic professionals. Among all psychometric diagnostic devices two scales – the „Social Phobia Inventory” (SPIN) with 17 items and its short-version the Mini-SPIN with only three Items – have proved to be especially economic and sensitive correctly differentiating almost 90% of all patients with social phobia. Implementation of such modern standardized diagnostic scales for the purpose of screening for social phobia in general and psychiatric primary care can substantially contribute to the early diagnosis and duly specific treatment initialization, as well as prevention of chronification of social phobic symptoms and development of comorbide disorders.

Schlüsselwörter

Soziale Phobie - Diagnostik - Komorbidität - Screening - Social Phobia Inventory - Mini Social Phobia Inventory

Keywords

Social phobia - diagnostics - comorbidity - screening - Social Phobia Inventory - Mini Social Phobia Inventory

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