Are social phobia and paranoia related, and which comes first?

k18705226-524414075 (online) Social phobia (SPh) and paranoid symptoms (PS) are associated. They may overlap because they share psychological and behavioural mechanisms such as selective attention for social threats and avoidance behaviour. Possibly, one leads to the other. The aim of this study is to explore the association between SPh and PS in a prospective general population sample. Adults (7076) from the NEMESIS general population were assessed for SPh and PS using the Composite International Diagnostic Interview (CIDI) at baseline, and one and three years later. Odds ratios, dose–response relationships and confidence intervals were calculated. Lifetime SPh and PS were associated (OR=3.08; 95% CI=2.49–3.82; p<.001), with a dose response. SPh emerging after PS was significant (OR=4.07; 95% CI=2.50–6.63; p<.001), also with a dose response, i.e. more PS symptoms yield more SPh symptoms. PS emerging after SPh was not significant. This study confirmed the association of SPh and PS in a general population. Possibly this is caused by shared underlying psychological and behavioural processes. There was some indication that paranoid ideation precedes the development of SPh, but this must be considered with caution. Clinical implications are discussed. Keywords: paranoid symptoms; social phobia; comorbidity; general population surve