{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T05:12:41Z","timestamp":1791954761752,"version":"4.3.4"},"reference-count":44,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"unspecified","delay-in-days":3045,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J\n                        Psychiatry"],"published-print":{"date-parts":[[2009,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Social anxiety disorder constitutes a significant problem for people with\n                           psychosis. It is unclear whether this is a by-product of persecutory\n                           thinking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To compare the phenomenology of social anxiety disorder in first-episode\n                           psychosis with that in a group without psychosis. The relationship\n                           between social anxiety and psychosis symptoms was investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A sample of people with first-episode psychosis (FEP group) was compared\n                           with a sample with social anxiety disorder without psychosis (SaD\n                           group).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the individuals in the FEP group (n = 80) 25% were diagnosed with an\n                           ICD\u201310 social anxiety disorder (FEP\/SaD group); a further 11.6% reported\n                           severe difficulties in social encounters. The FEP\/SaD and SaD groups\n                           reported comparable levels of social anxiety, autonomic symptoms,\n                           avoidance and depression. Social anxiety in psychosis was not related to\n                           the positive symptoms of the Positive and Negative Syndrome Scale (PANSS)\n                           including suspiciousness\/persecution. However, a significantly greater\n                           percentage of socially anxious <jats:italic>v.<\/jats:italic> non-socially anxious\n                           individuals with psychosis expressed perceived threat from persecutors,\n                           although this did not affect the severity of social anxiety within the\n                           FEP\/SaD group. The majority of those in the FEP\/SaD group did not have\n                           concurrent persecutory delusions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Social anxiety is a significant comorbidity in first-episode psychosis.\n                           It is not simply an epiphenomenon of psychotic symptoms and clinical\n                           paranoia, and it has more than one causal pathway. For a subgroup of\n                           socially anxious people with psychosis, anticipated harm is present and\n                           the processes that underlie its relationship with social anxiety warrant\n                           further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.bp.108.053124","type":"journal-article","created":{"date-parts":[[2009,8,31]],"date-time":"2009-08-31T23:23:17Z","timestamp":1251760997000},"page":"234-241","source":"Crossref","is-referenced-by-count":120,"title":["Social anxiety disorder in first-episode psychosis: incidence,\n                        phenomenology and relationship with paranoia"],"prefix":"10.1192","volume":"195","author":[{"given":"Maria","family":"Michail","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Birchwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2018,1,2]]},"reference":[{"key":"S0007125000250162_ref18","volume-title":"Schedules for Clinical Assessment in Neuropsychiatry","year":"1999"},{"key":"S0007125000250162_ref5","article-title":"An investigation of the post-psychotic depressive symptom","volume":"133","author":"McGlashan","year":"1976","journal-title":"Am J Psychol"},{"key":"S0007125000250162_ref4","article-title":"Pathogenesis of schizophrenia: a psychopathological perspective","volume":"186","author":"Cunningham Owens","year":"2005","journal-title":"Br J Psychiatry"},{"key":"S0007125000250162_ref25","doi-asserted-by":"publisher","DOI":"10.1017\/S003329170100455X"},{"key":"S0007125000250162_ref36","article-title":"Major depression in patients with social phobia","volume":"147","author":"Stein","year":"1990","journal-title":"Am J Psychiatry"},{"key":"S0007125000250162_ref37","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1992.01820040034004"},{"key":"S0007125000250162_ref42","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291707000499"},{"key":"S0007125000250162_ref2","article-title":"Depression in first-episode schizophrenia","volume":"150","author":"Koreen","year":"1993","journal-title":"Am J Psychol"},{"key":"S0007125000250162_ref33","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.60.11.1117"},{"key":"S0007125000250162_ref40","doi-asserted-by":"publisher","DOI":"10.1097\/01.nmd.0000161686.53245.70"},{"key":"S0007125000250162_ref28","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.184.4.312"},{"key":"S0007125000250162_ref15","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.2.400-a"},{"key":"S0007125000250162_ref32","doi-asserted-by":"publisher","DOI":"10.1002\/da.10083"},{"key":"S0007125000250162_ref21","article-title":"Development and validation of measures of social phobia and scrutiny fear and social interaction anxiety","volume":"36","author":"Mattick","year":"1998","journal-title":"Behav Res Ther"},{"key":"S0007125000250162_ref24","volume-title":"Social Phobia: Clinical and Research Perspective","author":"Cox","year":"1995"},{"key":"S0007125000250162_ref1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291704003745"},{"key":"S0007125000250162_ref41","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.186.5.427"},{"key":"S0007125000250162_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/S0920-9964(02)00292-X"},{"key":"S0007125000250162_ref19","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/13.2.261"},{"key":"S0007125000250162_ref20","volume-title":"The ICD\u201310 Classification of Mental and Behavioural Disorders","year":"1993"},{"key":"S0007125000250162_ref8","article-title":"Multiple anxiety disorder comorbidity in patients with mood spectrum disorders with psychotic features","volume":"156","author":"Cassano","year":"1999","journal-title":"Am J Psychol"},{"key":"S0007125000250162_ref10","article-title":"Social anxiety in outpatients with schizophrenia. 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