1801 – The Prognosis Of Specific Phobia In The Elderly Population: a 5-year Follow-up Study

Abstract

Introduction

Specific phobia (SP) is prevalent in the population but its clinical relevance is unclear.

Objectives

There are few prospective population studies of SP.

Aim

To study the prognosis of SP in a sample of elderly with special reference to SP as a risk factor for depression.

Material and methods

A representative sample of 70-year old men and women (N=558) without dementia were examined by psychiatric nurses, using a semi-structured interview based on the Comprehensive Psychopathological Rating Scale (CPRS). Symptom algorithms were used to diagnose SP and other disorders of mood and anxiety according to DSM-IV. At a 5-year follow-up 418 (74.9%) persons were re-examined.

Results

The prevalence of SP had declined significantly from 10.2% to 6.1% at follow-up. Of those with SP at baseline, 28.6% met diagnostic criteria also at follow-up, 52.4% had sub-clinical symptoms and 19.0% had no symptoms at follow-up. The prognosis of SP was not influenced by psychiatric comorbidity or type of fear. SP at baseline increased the risk for depression at follow-up in a logistic regression model also including gender and other anxiety disorders.

Conclusion

Less than a third of those with SP meet criteria at a 5-year follow-up, indicating substantial fluctuation of symptom levels of SP. The marked reduction in prevalence of SP over time suggests that age in itself may have a positive influence on the prognosis. The increased risk for depression in this study calls for more prospective studies in younger samples.