Social phobia is clearly a chronic and potentially severe functional impairment, and it has been found that more than half of patients with social phobia have significant functional impairment in some area of their lives, independent of the level of social support. Predictors of a good prognosis for social phobia are onset after age 11, absence of psychiatric co-morbidity and high educational attainment. Co-morbid avoidant personality disorder was reported to predict a 41% reduction in the likelihood of social phobia remission. In a large retrospective survey of individuals aged 25-64 years with lifelong social phobia, nearly half of the sample had recovered from the disorder at the time of the survey, and the median duration of illness was 25 years. Significant predictors of recovery were social background in childhood, such as no siblings and small town upbringing, initial episodes after age 7, fewer symptoms, and no co-morbid health problems or depression or co-morbidities that appeared before the onset of social phobia. And another study confirmed a better prognosis for later onset (especially adult onset) medication, which was more in terms of symptom improvement but also in terms of impairment in occupational functioning and even in terms of severity and duration of illness. In a prospective epidemiological study, adolescents and young adults with social anxiety disorder who were not depressed at baseline were associated with an elevated likelihood of depressive disorder during 3-4 years of follow-up; moreover, co-occurring social anxiety was associated with a more malignant course of depression in adolescents who were already depressed.