[Social phobia with interpersonal attitude delusions on the background of endogenous diseases].

The paper presents data on 38 patients with slow-progredient schizophrenia and cyclothymia with clinical picture of social phobias combined with sensitive ideas of reference. Two types of such states were singled out: social phobia of self-insufficiency with isolated sensitive ideas of reference (13 patients) and social phobia with the ideas of physical or mental defect and generalized ideas of reference (25 cases). The states of the first type were observed in the structure of circular melancholic depressions and were characterised by the presence of the ideas of low self-esteem. Phobic avoidance is low expressed, sensitive ideas of the reference are fragmental and transitory. Social adaptation was not, as a rule, changed in such cases or was changed insignificantly. The states of the second type were registered at simple and psychopathic-like variations of slow-progredient schizophrenia and were characterized by generalized anxiety in all situations concerning appearance in public. The contents of social phobia is a supposition of a physic or mental defect. The peculiarities of the states of this type are the presence of generalized sensitive ideas of reference, total avoidance and lack of the connection between anxious-phobic symptomatology and manifestations of comorbid affective disorders in the form of prolonged depressions of dysthymic level. The course of the disease is chronic, without remissions. Prognosis of social phobia of the second type is unfavourable.