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F40.10·CIM-10-CM

Social Anxiety Disorder, Unspecified (Social Phobia)

Marked fear or anxiety about social situations where the person may be scrutinized, lasting at least six months and causing clinically significant distress or impairment.

Outil de dépistage recommandé

Outil de dépistage validé
Liebowitz Social Anxiety Scale (LSAS)
Voir l'échelle

DSM-5-TR diagnostic criteria summary

Social Anxiety Disorder requires:

  • Marked fear or anxiety about one or more social situations where the person is exposed to possible scrutiny by others (social interactions, being observed, performing).
  • Fear of acting in a way or showing anxiety symptoms that will be negatively evaluated (humiliating, embarrassing, leading to rejection, or offending others).
  • Social situations almost always provoke fear or anxiety.
  • Social situations are avoided or endured with intense fear or anxiety.
  • The fear is out of proportion to the actual threat posed by the situation and to the sociocultural context.
  • Fear, anxiety, or avoidance is persistent, typically lasting 6 months or more.
  • Causes clinically significant distress or impairment.
  • Not attributable to a substance or another medical condition, and not better explained by another mental disorder.

Specifier: "Performance only" (F40.11), fear restricted to performing in public.

Source: American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), p. 229–235.

Differential diagnosis

  • F41.1 Generalized Anxiety Disorder, pervasive worry across multiple domains, not specifically tied to social scrutiny.
  • F41.0 Panic Disorder, recurrent unexpected panic attacks; situational panic in SAD is cued by social exposure.
  • F40.00 Agoraphobia, fear of public/open spaces specifically related to escape difficulty, not social evaluation.
  • F84.0 Autism Spectrum Disorder, social difficulties are pervasive and developmental; SAD social fear is driven by negative-evaluation cognitions, not social communication deficits.
  • F60.6 Avoidant Personality Disorder, extensive overlap with SAD; APD characterized by stable, broad avoidance traits across most social interactions.
  • F32.x / F33.x Major Depressive Disorder, social withdrawal in depression is anhedonic, not driven by fear of evaluation.

Common comorbidities

Social Anxiety Disorder commonly co-occurs with other anxiety disorders, depression, and substance use disorders. Common comorbidities: Major Depressive Disorder (F33, F32), Generalized Anxiety Disorder (F41.1), Panic Disorder (F41.0), Alcohol Use Disorder (F10.20, alcohol often used as social anxiety self-medication). Co-administer PHQ-9, GAD-7, and AUDIT alongside the LSAS or SPIN.

Sources

  • American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), F40.10, p. 229–235.
  • Liebowitz, M. R. (1987). Social phobia. Modern Problems of Pharmacopsychiatry, 22, 141–173.
  • Centers for Disease Control and Prevention. ICD-10-CM Official Coding Guidelines.

Foire aux questions

What is ICD-11 code F40.10?

F40.10 is the ICD-11-CM code for Social Anxiety Disorder (Social Phobia), Unspecified, used when DSM-5-TR criteria for SAD are met without specifying performance-only subtype. F40.11 is the performance-only specifier.

What are the diagnostic criteria for F40.10?

DSM-5-TR requires marked fear or anxiety about social situations where the person may be scrutinized, fear of acting in a way that will be negatively evaluated, social situations almost always provoke fear, situations are avoided or endured with intense anxiety, fear is out of proportion to actual threat, persistent (typically ≥6 months), causes clinically significant distress or impairment, and not better explained by another condition.

What scale is used to screen for F40.10?

Two well-validated screeners: the Liebowitz Social Anxiety Scale (LSAS) is a 24-item clinician- or self-rated scale (cutoff ≥30 for SAD); the Social Phobia Inventory (SPIN) is a 17-item self-report (cutoff ≥19). Both have strong sensitivity and specificity for distinguishing SAD from healthy controls.

What is the difference between F40.10 and F40.11?

F40.10 is Social Anxiety Disorder, Unspecified, applied when fear extends across multiple social situations. F40.11 is the Performance Only specifier, applied when fear is restricted to performing in public (e.g., public speaking, performing music) without anxiety in other social contexts.

Is F40.10 the same as social phobia?

Yes. 'Social phobia' is the older terminology used in DSM-IV and earlier ICD-11. DSM-5-TR officially renamed the diagnosis 'Social Anxiety Disorder' in 2013; both terms refer to F40.10 in ICD-11-CM coding.

Is F40.10 a billable ICD-11-CM code?

Yes, F40.10 is a billable ICD-11-CM code as of the 2025 official tabular list. It is the most commonly reimbursed code for Social Anxiety Disorder when fear extends across multiple social situations. F40.11 (Social Anxiety Disorder, Performance Only) is also billable when fear is limited to public performance.

What are the symptoms of social anxiety disorder?

Social anxiety disorder produces marked fear of social or performance situations where the person may be scrutinized. Core symptoms include intense fear of being judged, humiliated, or rejected; avoidance of social events, public speaking, eating in public, or initiating conversation; and physical signs such as blushing, sweating, trembling, racing heart, or nausea when exposure occurs. Symptoms are out of proportion to the actual threat and persist for at least six months.

How is social anxiety disorder diagnosed?

Social anxiety disorder is diagnosed by a clinician using DSM-5-TR criteria, which require persistent fear and avoidance of social scrutiny lasting at least six months and causing clinically significant distress or impairment. Diagnosis typically follows a positive LSAS (cutoff 30+) or SPIN (cutoff 19+) screen, structured clinical interview, ruling out medical and substance-induced causes, and screening for comorbid depression and alcohol use.

What causes social anxiety disorder?

Social anxiety disorder arises from a combination of genetic, neurobiological, and environmental factors. Heritability estimates from twin studies range from 30% to 50%. Neurobiological contributors include heightened amygdala reactivity to social threat cues, altered serotonin and dopamine signaling, and increased anterior cingulate activation. Environmental triggers include childhood social experiences (bullying, criticism, overprotection), early shyness or behavioral inhibition, and traumatic social events.

Can social anxiety disorder be cured?

Social anxiety disorder is highly treatable and many patients achieve full or substantial remission. Cognitive behavioral therapy with exposure exercises is the first-line treatment, with response rates of 60% to 80% across well-designed trials. SSRIs and SNRIs are first-line medications. Without treatment, social anxiety tends to be chronic and is associated with elevated risk of depression and alcohol use disorder, which is why early intervention matters.

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