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Taijin kyofusho is a culture-bound, anxiety-related syndrome seen primarily in Japan and East Asia. The “typical subtype” is characterized by a fear of being noticed and is similar to social-anxiety disorder. The “offensive subtype” involves fears of offending others by one’s body appearance, odor, facial expressions, or movements. In the U.S., it might be diagnosed as delusional disorder, body dysmorphic disorder, obsessive-compulsive disorder, or social anxiety disorder.
In this 12-week, open-treatment trial, 22 outpatients with the offensive subtype of taijin kyofusho were treated with psychoeducation and paroxetine (target dosage, 40 mg/day; mean dosage at 12 weeks, 38.4 mg/day). All patients also met criteria for generalized social anxi…