Although social phobia has previously been thought to be rare among the elderly, a new thesis shows that as many as 60,000 Swedes over the age of 65 may experience fear before going out and eating at restaurants, meeting other people or speaking to a group.

“This is a forgotten disorder among the elderly,” says Björn Karlsson, a doctoral student at the University of Gothenburg’s Sahlgrenska Academy. “I find this tragic, since social phobia leads to isolation and poorer mental health, and yet effective treatment is available.”

His thesis shows that modern diagnostic criteria do not work for elderly patients. These criteria only capture half of patients suffering from social phobia over the age of 65.

“It’s important that doctors and other care workers who come into contact with the elderly are aware that social phobia is such a common phenomenon among older people, so that they can be vigilant and can offer cognitive behavioural therapy or antidepressants to those patients who need them.”

Nevertheless, Björn’s thesis shows that the prognosis for social phobia is good. When the elderly Gothenburg residents included in the study were followed up five years later, half of them had shown a significant improvement without treatment.

“However, during the same period roughly as many had started to suffer from social phobia, which suggests that the intensity of the disorder varies over time,” continues Björn, who also noted that those who suffer from social phobia often suffer from depression, too:

“This is partly due to the fact that people with certain character traits have a higher risk of both social phobia and depression.”

The thesis is based on the well-known H70 and H85 population studies, which have been carried out in Gothenburg among people over the age of 70 since 1971.

The thesis Social phobia among the elderly was defended on 24 May.

Björn Karlsson, physician and doctoral student at the Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg
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Main supervisor: Professor Ingmar Skoog, +46 (0)709 43 36 81