TITLE:
Taijin-Kyofu-Sho: A subtype of social anxiety
AUTHORS:
Leslie Lim
KEYWORDS:
Taijin-Kyofu-Sho; Social Anxiety Disorder; Cultural Factors; Treatment
JOURNAL NAME:
Open Journal of Psychiatry,
Vol.3 No.4,
October
14,
2013
ABSTRACT:
Taijin-Kyofu-Sho (TKS) has long been considered as a
Japanese culture-bound form of social anxiety disorder, although subsequent
case-reports from countries outside Japan have dispelled this notion. There are subtle yet distinct differences between TKS and
DSM-defined social anxiety disorder (SAD). For instance, the TKS subject fears causing offence to others, whereas the SAD subject is more fearful of causing
embarrassment to him/herself. Four sub-categories of TKS have been recognised
of which the Jikoshu-kyofu variety resembles the olfactory reference syndrome
(ORS) known to Western psychiatrists. There are
two TKS subtypes, general (or
simple) and offensive (delusional). The general subtype resembles social anxiety
disorder, whereas the offensive subtype is characterised by delusions. True
community-wide prevalence is unknown, although clinic studies estimate between 7.8% to 45.5% patients have a diagnosis of TKS, with a
slight male preponderance. Cultural and societal norms engendering guilt,
shame, and embarrassment are likely etiological factors. Treatment may consist
of antidepressant and/or antipsychotic medications, while some patients may
also benefit from cognitive behavior therapy.