Social Anxiety Spectrum: Gender Differences in Italian High School Students LILIANA DELL’OSSO, M.D., 1 MARCO SAETTONI, M.D., 1 ALESSANDRA PAPASOGLI, M.D., 1 PAOLA RUCCI, D.STAT., 1 ANTONIO CIAPPARELLI, M.D., 1 ADOLFO BANDETTINI DI POGGIO, M.D., 1 FRANCESCA DUCCI, M.D., 1 CAROLINA HARDOY, M.D., 1 and GIOVANNI BATTISTA CASSANO, M.D., F.R.C.PSYCH. 1 Gender differences in the social anxiety spectrum and their correlation with other psychopathological features were analyzed in 520 students by using two question- naires: the Social Anxiety Spectrum Self-Report (SHY-SR), which explores social anxiety spectrum, and the General Spectrum Measure (GSM), which explores panic-agoraphobia, mood, obsessive-compulsive, and eating-behavior features. Mean SHY-SR total score was significantly higher in women than in men, and gender differences were particularly pronounced for interpersonal sensitivity domain. Like- wise, GSM scores were higher in women, except for the manic section. The SHY-SR domains correlated significantly with all GSM sections, except for the manic sec- tion. In conclusion, women reported more symptoms than men (who belonged to different psychopathologic dimensions) and displayed a profile of social anxiety spectrum that differs quantitatively but not qualitatively from the men’s profile. The correlation between social anxiety spectrum and other psychopathological features mirrors previous findings concerning the high comorbidity of axis-I social anxiety disorder. —J Nerv Ment Dis 190:225–232, 2002 Social anxiety disorder (SAD), defined as “marked and persistent fear of one or more social or perfor- mance situations in which the person is exposed to unfamiliar people, or to possible scrutiny by others” (American Psychiatric Association, 1994), is the most prevalent anxiety disorder and the third most common psychiatric disorder in the general population (Kessler et al., 1994). The onset of SAD usually occurs in child- hood or adolescence, goes frequently untreated, and is associated with poor school and work performance (Wittchen et al., 1999). Converging evidence indicates that patients with SAD have higher risk of comor- bidity with other anxiety disorders, mood disorders, and substance abuse disorders, as compared with patients without the disorder (Merikangas et al., 1998; Stein et al., 2001). Also, psychotic disorders often present a comorbidity for SAD (Cassano et al., 1998; Kendler et al., 1996, Kessler et al., 1997; Pini et al., 1999; Strakowski et al., 1993). The prevalence of SAD has been consistently shown to be higher among women than men, among younger age than older age cohorts, and is associ- ated with poor grades and early behavioral difficul- ties (Lang and Stein, 2001; Stein and Kean, 2000). Although the overall prevalence appears to vary ac- cording to the population considered and the diag- nostic criteria applied, the ratio between female and male rates is quite stable across studies (approxi- mately 1.5 to 2.1; Kessler et al., 1994; Wittchen et al., 1999). In the Epidemiological Catchment Area study, the lifetime prevalence rate of SAD was 3.1% in women and 2.0% in men (Schneier et al., 1992), and in the National Comorbidity Survey study, the cor- responding figures were 15.5% and 11.1%, respec- tively (Magee et al., 1996). Gender differences in the symptom profile of SAD have been reported (Turk et al., 1998; Weinstock, 1999; Wittchen et al., 1999). Turk et al. (1998) re- ported that women have greater fear than men in the following situations: talking to an authority figure; acting, performing, or giving a talk in front of an audience; working while being observed; entering a room when others are already seated; being the center of attention; speaking up at a meeting; ex- pressing disagreement or disapproval to people they do not know very well; giving a report to a group; and giving a party. Men reported significantly more 1 Department of Psychiatry, Neurobiology, Pharmacology, and Biotechnologies, University of Pisa, Via Roma n. 67, 56127 Pisa, Italy; e-mail ldelloss@med.unipi.it. Send reprint requests to Dr. Dell’Osso. The authors thank the Director of Education in Pisa Rocco Lista; the Headmasters Carlo Manfredonia, Carmela Rosa Flecca, Carmelo Campagna, Lia Marianelli, and Maria Floria Bracci Marinai; and the teachers Carlo Castellani, Aurora De Leo, and Salvatore Roas for their collaboration in collecting data. 0022-3018/02/19004 –225 Vol. 190, No. 04 THE JOURNAL OF NERVOUS AND MENTAL DISEASE Printed in U.S.A. Copyright © 2002 by Lippincott Williams & Wilkins DOI: 10.1097/01.NMD.0000012870.67518.25 225