JAWAL-3LMNY

31Y politician has a sudden onset of extreme anxiety, tremulousness and diaphoresis immediately before his first scheduled appearance on national tv and he is unable to go on air.For the next week he is paralyzed by fear each time he faces an audience and he cancels all of his scheduled public appearances. WHAT IS THE MOST LIKELY DIAGNOSIS?

1.ACUTE STRESS DISORDER
2.ADUSTMENT DISORDER WITH ANXIOUS MOOD
3.PANIC DISORDER
4.SOCIAL PHOBIA
5.SPECIFIC PHOBIA

ANSWER:4. This presentation is most suggestive of social phobia. In this case, exposure to public speaking precipitated a panic attack. Panic disorder is also characterized by panic attacks; however, there is no clear precipitant. Specific phobia, situational type, is less likely diagonsis, because there is no specific cause of the fear other than social exposure. Acute stress disorder is characyerized by the presence of intrusive recollections and emotional numbing that follow a severely stressful event. Adjustment disorder with anxious mood is characterized by an adaptation problem that follows a psychologic stressor, of which there is no evidence in this case.