Hikikomori may serve as a proxy for a severe form of SAD. Patients with comorbid SAD and hikikomori have lower treatment response rates than those with SAD alone.

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Aim:The aim of the current study was to study the psychometric properties of the Japanese version of the Social Phobia Inventory (SPIN-J) among Japanese subjects with social anxiety disorder (SAD). Method:The sample consisted of 86 subjects with SAD and 86 controls. Diagnosis was based on a modified version of the Structured Clinical Interview for the DSM-IV. In addition to the SPIN-J, clinicianadministered and self-rating scales, including the Japanese versions of the Liebowitz Social Anxiety Scale, the Social Phobia Scale, and the Social Interaction Anxiety Scale, were used. Results:The SPIN-J showed adequate internal consistency (0.82-0.96) for the total and subscales.Correlations between the SPIN-J and the Liebowitz Social Anxiety Scale, the Social Phobia Scale, and the Social Interaction Anxiety Scale ranged from 0.83 to 0.89 and indicated adequate concurrent validity. A cut-off point of 22 between subjects with SAD and controls showed a sensitivity of 96.5% and specificity of 87.2%, indicating robust discriminant validity. Conclusion:The SPIN-J showed adequate reliability and validity for use as a screening tool for social anxiety disorder in Japanese clinical settings.

BackgroundScreening scales for bipolar disorder including the Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Diagnostic Scale (BSDS) have been plagued by high false positive rates confounded by presence of borderline personality disorder. This study examined the accuracy of these scales for detecting bipolar disorder among patients referred for eating disorders and explored the possibility of simultaneous assessment of co-morbid borderline personality disorder.MethodsParticipants were 78 consecutive female patients who were referred for evaluation of an eating disorder. All participants completed the mood and eating disorder sections of the SCID-I/P and the borderline personality disorder section of the SCID-II, in addition to the MDQ and BSDS. Predictive validity of the MDQ and BSDS was evaluated by Receiver Operating Characteristic analysis of the Area Under the Curve (AUC).ResultsFifteen (19%) and twelve (15%) patients fulfilled criteria for bipolar II disorder and borderline personality disorder, respectively. The AUCs for bipolar II disorder were 0.78 (MDQ) and 0.78 (BDSD), and the AUCs for borderline personality disorder were 0.75 (MDQ) and 0.79 (BSDS).ConclusionsAmong patients being evaluated for eating disorders, the MDQ and BSDS show promise as screening questionnaires for both bipolar disorder and borderline personality disorder.

Aims: Recent studies have revealed the possibility that the offensive subtype of social anxiety disorder (SAD) may no longer be a culture-bound syndrome; however, detailed clinical pictures have never been reported. This study investigated the differences between the offensive and non-offensive subtypes of SAD in terms of the background and axis I and II comorbidity.Methods: A total of 139 patients with SAD based on DSM-IV criteria were studied by conducting a semistructured interview including the Structured Clinical Interview for DSM-IV axis I and II disorders, and the Liebowitz Social Anxiety Scale.Results: Fifty-two (37%) patients were classified with the offensive subtype. There were no significant differences in most demographic variables and axis I lifetime comorbidity between offensive and nonoffensive subtype patients. On logistic regression analysis, offensive subtype patients showed a more frequent history of parental physical abuse, higher Liebowitz Social Anxiety Scale scores, and more frequently exhibited obsessive-compulsive personality disorders than non-offensive subtype patients. Yamashita (1977) reported that the majority of offensive subtype patients were doted on by their parents, although current offensive subtype patients are more likely to have had a troubled childhood, show severer forms of SAD, and more frequently exhibit an inflexible personality. This study suggested that the offensive subtype might not be essentially different from the non-offensive subtype (quantitative rather than qualitative). Conclusion: