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The cross-national epidemiology of specific phobia in the World Mental Health Surveys

Published online by Cambridge University Press:  22 February 2017

K. J. Wardenaar ,
C. C. W. Lim ,
A. O. Al-Hamzawi ,
J. Alonso ,
L. H. Andrade ,
C. Benjet ,
B. Bunting ,
G. de Girolamo ,
K. Demyttenaere  and
S. E. Florescu
...Show all authors
K. J. Wardenaar*
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
C. C. W. Lim
Affiliation:
Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
A. O. Al-Hamzawi
Affiliation:
College of Medicine, Al-Qadisiya University, Al Diwaniya City, Iraq
J. Alonso
Affiliation:
Health Services Research Unit, Instituto Hospital del Mar de Investigaciones Médicas, Institut de Recerca Hospital del Mar, Barcelona, Spain
L. H. Andrade
Affiliation:
Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
C. Benjet
Affiliation:
Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
B. Bunting
Affiliation:
Psychology Research Institute, Ulster University, Londonderry, UK
G. de Girolamo
Affiliation:
IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
K. Demyttenaere
Affiliation:
Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium
S. E. Florescu
Affiliation:
National School of Public Health, Management and Professional Development, Bucharest, Romania
O. Gureje
Affiliation:
Department of Psychiatry, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
T. Hisateru
Affiliation:
National Institute of Mental Health, National Center for Neurology and Psychiatry, Tokyo, Japan
C. Hu
Affiliation:
Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Guangdong Province, People's Republic of China
Y. Huang
Affiliation:
Institute of Mental Health, Peking University, Beijing, People's Republic of China
E. Karam
Affiliation:
St George Hospital University Medical Center, Balamand University, Institute for Development, Research, Advocacy, Beirut, Lebanon
A. Kiejna
Affiliation:
Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
J. P. Lepine
Affiliation:
Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris INSERM UMR-S 1144, Paris Diderot University and Paris Descartes University, Paris, France
F. Navarro-Mateu
Affiliation:
Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, Centro de Investigación Biomédica en Red, Epidemiología y Salud Pública (CIBERESP)-Murcia, Subdirección General de Salud Mental y Asistencia Psiquiátrica, Servicio Murciano de Salud, El Palmar (Murcia), Spain
M. Oakley Browne
Affiliation:
Department of Psychiatry, Monash University, Melbourne, VIC, Australia
M. Piazza
Affiliation:
National Institute of Health, Lima, Peru Universidad Cayetano Hereidia, St Martin de Porres, Peru
J. Posada-Villa
Affiliation:
El Bosque University, Bogota, Colombia
M. L. ten Have
Affiliation:
Trimbos Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
Y. Torres
Affiliation:
Center for Excellence on Research in Mental Health, CES University, Medellín, Colombia
M. Xavier
Affiliation:
Nova faculdade ciencias medicas, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
Z. Zarkov
Affiliation:
Directorate Mental Health, National Center of Public Health and Analyses, Sofia, Bulgaria
R. C. Kessler
Affiliation:
Department of Health Care Policy, Harvard University Medical School, Boston, MA, USA
K. M. Scott
Affiliation:
Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
P. de Jonge
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
*
*Address for correspondence: K. J. Wardenaar, Ph.D., Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, PO Box 30.001, 9700RB Groningen, The Netherlands. (Email: k.j.wardenaar@umcg.nl)
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Abstract

Background

Although specific phobia is highly prevalent, associated with impairment, and an important risk factor for the development of other mental disorders, cross-national epidemiological data are scarce, especially from low- and middle-income countries. This paper presents epidemiological data from 22 low-, lower-middle-, upper-middle- and high-income countries.

Method

Data came from 25 representative population-based surveys conducted in 22 countries (2001–2011) as part of the World Health Organization World Mental Health Surveys initiative (n = 124 902). The presence of specific phobia as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition was evaluated using the World Health Organization Composite International Diagnostic Interview.

Results

The cross-national lifetime and 12-month prevalence rates of specific phobia were, respectively, 7.4% and 5.5%, being higher in females (9.8 and 7.7%) than in males (4.9% and 3.3%) and higher in high- and higher-middle-income countries than in low-/lower-middle-income countries. The median age of onset was young (8 years). Of the 12-month patients, 18.7% reported severe role impairment (13.3–21.9% across income groups) and 23.1% reported any treatment (9.6–30.1% across income groups). Lifetime co-morbidity was observed in 60.5% of those with lifetime specific phobia, with the onset of specific phobia preceding the other disorder in most cases (72.6%). Interestingly, rates of impairment, treatment use and co-morbidity increased with the number of fear subtypes.

Conclusions

Specific phobia is common and associated with impairment in a considerable percentage of cases. Importantly, specific phobia often precedes the onset of other mental disorders, making it a possible early-life indicator of psychopathology vulnerability.

Keywords

Co-morbiditycross-national studiesepidemiologyimpairmentspecific phobia

Information

Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 10 , July 2017 , pp. 1744 - 1760
Copyright
Copyright © Cambridge University Press 2017 

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