Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-26T20:45:47.611Z Has data issue: false hasContentIssue false
  • English
  • Français

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: [email protected])
Get access Rights & Permissions [Opens in a new window]

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alonso, J, Angermeyer, MC, Bernert, S, Bruffaerts, R, Brugha, TS, Bryson, H, de Girolamo, G, Graaf, R, Demyttenaere, K, Gasquet, I, Haro, JM, Katz, SJ, Kessler, RC, Kovess, V, Lépine, JP, Ormel, J, Polidori, G, Russo, LJ, Vilagut, G, Almansa, J, Arbabzadeh-Bouchez, S, Autonell, J, Bernal, M, Buist-Bouwman, MA, Codony, M, Domingo-Salvany, A, Ferrer, M, Joo, SS, Martínez-Alonso, M, Matschinger, H, Mazzi, F, Morgan, Z, Morosini, P, Palacín, C, Romera, B, Taub, N, Vollebergh, WA; ESEMeD/MHEDEA 2000 Investigators, European Study of the Epidemiology of Mental Disorders (ESEMeD) Project (2004). 12-Month comorbidity patterns and associated factors in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica. Supplementum 420, 28–37.Google Scholar
Andrade, LH, Alonso, J, Mneimneh, Z, Wells, JE, Al-Hamzawi, A, Borges, G, Bromet, E, Bruffaerts, R, de Girolamo, G, de Graaf, R, Florescu, S, Gureje, O, Hinkov, HR, Hu, C, Huang, Y, Hwang, I, Jin, R, Karam, EG, Kovess-Masfety, V, Levinson, D, Matschinger, H, O'Neill, S, Posada-Villa, J, Sagar, R, Sampson, NA, Sasu, C, Stein, DJ, Takeshima, T, Viana, MC, Xavier, M, Kessler, RC (2014). Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychological Medicine 44, 1303–1317.CrossRefGoogle ScholarPubMed
Angermeyer, MC, Dietrich, S (2006). Public beliefs about and attitudes towards people with mental illness: a review of population studies. Acta Psychiatrica Scandinavica 113, 163–179.CrossRefGoogle ScholarPubMed
Angst, J, Paksarian, D, Cui, L, Merikangas, KR, Hengartner, MP, Ajdacic-Gross, V, Rössler, W (2016). The epidemiology of common mental disorders from age 20 to 50: results from the prospective Zurich Cohort Study. Epidemiology and Psychiatric Science 25, 24–32.CrossRefGoogle ScholarPubMed
Becker, ES, Rinck, M, Türke, V, Kause, P, Goodwin, R, Neumer, S, Margraf, J (2007). Epidemiology of specific phobia subtypes: findings from the Dresden Mental Health Study. European Psychiatry 22, 69–74.CrossRefGoogle ScholarPubMed
Bijl, RV, De Graaf, R, Ravelli, A, Smit, F, Vollebergh, WA; Netherlands Mental Health Survey and Incidence Study (2002). Gender and age-specific first incidence of DSM-III-R psychiatric disorders in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Social Psychiatry and Psychiatric Epidemiology 37, 372–379.CrossRefGoogle ScholarPubMed
Bijl, RV, Ravelli, A, van Zessen, G (1998). Prevalence of psychiatric disorder in the general population: results of the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Social Psychiatry and Psychiatric Epidemiology 33, 587–595.CrossRefGoogle ScholarPubMed
Bittner, A, Goodwin, RD, Wittchen, HU, Beesdo, K, Höfler, M, Lieb, R (2004). What characteristics of primary anxiety disorders predict subsequent major depressive disorder? Journal of Clinical Psychiatry 65, 618–626.CrossRefGoogle ScholarPubMed
Burstein, M, Georgiades, K, He, JP, Schmitz, A, Feig, E, Khazanov, GK, Merikangas, K (2012). Specific phobia among U.S. adolescents: phenomenology and typology. Depression and Anxiety 29, 1072–1082.CrossRefGoogle ScholarPubMed
Choy, Y, Fyer, AJ, Lipsitz, JD (2007). Treatment of specific phobia in adults. Clinical Psychology Review 27, 266–286.CrossRefGoogle ScholarPubMed
Clement, S, Schauman, O, Graham, T, Maggioni, F, Evans-Lacko, S, Bezborodovs, N, Morgan, C, Rüsch, N, Brown, JS, Thornicroft, G (2015). What is the impact of mental health related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine 45, 11–27.CrossRefGoogle ScholarPubMed
Comer, JS, Blanco, C, Hasin, DS, Liu, SM, Grant, BF, Turner, JB, Olfson, M (2011). Health-related quality of life across the anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Journal of Clinical Psychiatry 72, 43–50.CrossRefGoogle ScholarPubMed
Curtis, GC, Magee, WJ, Eaton, WW, Wittchen, HU, Kessler, RC (1998). Specific fears and phobias. Epidemiology and classification. British Journal of Psychiatry 173, 212–217.Google ScholarPubMed
de Graaf, R, ten Have, M, van Gool, C, van Dorsselaer, S (2012). Prevalence of mental disorders and trends from 1996 to 2009. Results from the Netherlands Mental Health Survey and Incidence Study-2. Social Psychiatry and Psychiatric Epidemiology 47, 203–213.CrossRefGoogle ScholarPubMed
Depla, MF, ten Have, ML, van Balkom, AJ, de Graaf, R (2008). Specific fears and phobias in the general population: results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Social Psychiatry and Psychiatric Epidemiology 43, 200–208.CrossRefGoogle ScholarPubMed
Fredrikson, M, Annas, P, Fischer, H, Wik, G (1996). Gender and age differences in the prevalence of specific fears and phobias. Behaviour Research and Therapy 34, 33–39.CrossRefGoogle ScholarPubMed
Goisman, RM, Allsworth, J, Rogers, MP, Warshaw, MG, Goldenberg, I, Vasile, RG, Rodriguez-Villa, F, Mallya, G, Keller, MB (1998). Simple phobia as a comorbid anxiety disorder. Depression and Anxiety 7, 105–112.3.0.CO;2-A>CrossRefGoogle ScholarPubMed
Goodwin, RD (2002). Anxiety disorders and the onset of depression among adults in the community. Psychological Medicine 32, 1121–1124.CrossRefGoogle ScholarPubMed
Grant, BF, Goldstein, RB, Chou, SP, Huang, B, Stinson, FS, Dawson, DA, Saha, TD, Smith, SM, Pulay, AJ, Pickering, RP, Ruan, WJ, Compton, WM (2009). Sociodemographic and psychopathologic predictors of first incidence of DSM-IV substance use, mood and anxiety disorders: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Molecular Psychiatry 14, 1051–1066.CrossRefGoogle ScholarPubMed
Grenier, S, Schuurmans, J, Goldfarb, M, Préville, M, Boyer, R, O'Connor, K, Potvin, O, Hudon, C; Scientific Committee of the ESA study (2011). The epidemiology of specific phobia and subthreshold fear subtypes in a community-based sample of older adults. Depression and Anxiety 28, 456–463.CrossRefGoogle Scholar
Halli, SS, Rao, KV, Halli, SS (1992). Advanced Techniques of Population Analysis. Plenum: New York.CrossRefGoogle Scholar
Harkness, J, Pennell, BE, Villar, A, Gebler, N, Aguilar-Gaxiola, S, Bilgen, I (2008). Translation procedures and translation assessment in the World Mental Health Survey Initiative. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. RC Kessler, and Üstün, TB), pp. 91–113. Cambridge University Press: New York.Google Scholar
Haro, JM, Arbabzadeh-Bouchez, S, Brugha, TS, de Girolamo, G, Guyer, ME, Jin, R, Lepine, JP, Mazzi, F, Reneses, B, Vilagut, G, Sampson, NA, Kessler, RC (2006). Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health surveys. International Journal of Methods in Psychiatric Research 15, 167–180.CrossRefGoogle ScholarPubMed
Hinton, DE, Pollack, MH (2009). Introduction to the special issue: anxiety disorders in cross-cultural perspective. CNS Neuroscience and Therapeutics 15, 207–209.CrossRefGoogle Scholar
Hofmann, SG, Hinton, DE (2014). Cross-cultural aspects of anxiety disorders. Current Psychiatry Reports 16, 450.CrossRefGoogle ScholarPubMed
Iza, M, Olfson, M, Vermes, D, Hoffer, M, Wang, S, Blanco, C (2013). Probability and predictors of first treatment contact for anxiety disorders in the United States: analysis of data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Journal of Clinical Psychiatry 74, 1093–1100.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593–602.CrossRefGoogle ScholarPubMed
Kessler, RC, Crum, RM, Warner, LA, Nelson, CB, Schulenberg, J, Anthony, JC (1997). Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity Survey. Archives of General Psychiatry 54, 313–321.CrossRefGoogle ScholarPubMed
Kessler, RC, McGonagle, KA, Zhao, S, Nelson, CB, Hughes, M, Eshleman, S, Wittchen, H-U, Kendler, KS (1994). Lifetime and 12 month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Archives of General Psychiatry 51, 8–19.CrossRefGoogle ScholarPubMed
Kessler, RC, Nelson, CB, McGonagle, KA, Liu, J, Swartz, M, Blazer, DG (1996). Comorbidity of DSM-III-R major depressive disorder in the general population: results from the US National Comorbidity Survey. British Journal of Psychiatry Supplement 30, 17–30.CrossRefGoogle Scholar
Kessler, RC, Üstün, TB (2004). The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93–121.CrossRefGoogle ScholarPubMed
Kessler, RC, Üstün, TB (2008). The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders. Cambridge University Press: New York.Google Scholar
LeBeau, RT, Glenn, D, Liao, B, Wittchen, HU, Beesdo-Baum, K, Ollendick, T, Craske, MG (2010). Specific phobia: a review of DSM-IV specific phobia and preliminary recommendations for DSM-V. Depression and Anxiety 27, 148–167.CrossRefGoogle ScholarPubMed
Lee, S, Juon, HS, Martinez, G, Hsu, CE, Robinson, ES, Bawa, J, Ma, GX (2009). Model minority at risk: expressed needs of mental health by Asian American young adults. Journal of Community Health 34, 144–152.CrossRefGoogle ScholarPubMed
Leon, AC, Olfson, M, Portera, L, Farber, L, Sheehan, DV (1997). Assessing psychiatric impairment in primary care with the Sheehan Disability Scale. International Journal of Psychiatry in Medicine 27, 93–105.CrossRefGoogle ScholarPubMed
Levinson, D, Lakoma, MD, Petukhova, M, Schoenbaum, M, Zaslavsky, AM, Angermeyer, M, Borges, G, Bruffaerts, R, de Girolamo, G, de Graaf, R, Gureje, O, Haro, JM, Hu, C, Karam, AN, Kawakami, N, Lee, S, Lepine, JP, Browne, MO, Okoliyski, M, Posada-Villa, J, Sagar, R, Viana, MC, Williams, DR, Kessler, RC (2010). Associations of serious mental illness with earnings: results from the WHO World Mental Health surveys. British Journal of Psychiatry 197, 114–121.CrossRefGoogle ScholarPubMed
Lieb, R, Miché, M, Gloster, AT, Beesdo-Baum, K, Meyer, AH, Wittchen, HU (2016). Impact of specific phobia on the risk of onset of mental disorders: a 10-year prospective longitudinal community study of adolescents and young adults. Depression and Anxiety 33, 667–675.CrossRefGoogle ScholarPubMed
Magee, WJ, Eaton, WW, Wittchen, HU, McGonagle, KA, Kessler, RC (1996). Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. Archives of General Psychiatry 53, 159–168.CrossRefGoogle ScholarPubMed
Marques, L, Robinaugh, DJ, LeBlanc, NJ, Hinton, D (2011). Cross-cultural variations in the prevalence and presentation of anxiety disorders. Expert Review of Neurotherapeutics 11, 313–322.CrossRefGoogle ScholarPubMed
McBain, R, Norton, DJ, Morris, J, Yasamy, MT, Betancourt, TS (2012). The role of health systems factors in facilitating access to psychotropic medicines: a cross-sectional analysis of the WHO-AIMS in 63 low- and middle-income countries. PLoS Medicine 9, e1001166.CrossRefGoogle ScholarPubMed
Moffitt, TE, Caspi, A, Taylor, A, Kokaua, J, Milne, BJ, Polanczyk, G, Poulton, R (2010). How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment. Psychological Medicine 40, 899–909.CrossRefGoogle ScholarPubMed
Ormel, J, Petukhova, M, Chatterji, S, Aguilar-Gaxiola, S, Alonso, J, Angermeyer, MC, Bromet, EJ, Burger, H, Demyttenaere, K, de Girolamo, G, Haro, JM, Hwang, I, Karam, E, Kawakami, N, Lépine, JP, Medina-Mora, ME, Posada-Villa, J, Sampson, N, Scott, K, Ustün, TB, Von Korff, M, Williams, DR, Zhang, M, Kessler, RC (2008). Disability and treatment of specific mental and physical disorders across the world. British Journal of Psychiatry 192, 368–375.CrossRefGoogle Scholar
Palazzo, MC, Dell'Osso, B, Altamura, AC, Stein, DJ, Baldwin, DS (2014). Health literacy and the pharmacological treatment of anxiety disorders: a systematic review. Human Psychopharmacology 29, 211–215.CrossRefGoogle ScholarPubMed
Saxena, S, Thornicroft, G, Knapp, M, Whiteford, H (2007). Resources for mental health: scarcity, inequity, and inefficiency. Lancet 370, 878–889.CrossRefGoogle ScholarPubMed
Semrau, M, Evans-Lacko, S, Koschorke, M, Ashenafi, L, Thornicroft, G (2015). Stigma and discrimination related to mental illness in low- and middle-income countries. Epidemiology and Psychiatric Science 24, 382–394.CrossRefGoogle ScholarPubMed
Sigström, R, Skoog, I, Karlsson, B, Nilsson, J, Östling, S (2016). Nine-year follow-up of specific phobia in a population sample of older people. Depression and Anxiety 33, 339–346.CrossRefGoogle Scholar
Stinson, FS, Dawson, DA, Chou, SP, Smith, S, Goldstein, RB, Ruan, WJ, Grant, BF (2007). The epidemiology of DSM-IV specific phobia in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychological Medicine 37, 1047–1059.CrossRefGoogle ScholarPubMed
ten Have, M, de Graaf, R, van Dorsselaer, S, Beekman, A (2013). Lifetime treatment contact and delay in treatment seeking after first onset of a mental disorder. Psychiatric Services 64, 981–989.CrossRefGoogle ScholarPubMed
Trumpf, J, Margraf, J, Vriends, N, Meyer, AH, Becker, ES (2010). Specific phobia predicts psychopathology in young women. Social Psychiatry and Psychiatric Epidemiology 45, 1161–1166.CrossRefGoogle ScholarPubMed
Wells, JE, Browne, MA, Scott, KM, McGee, MA, Baxter, J, Kokaua, J; New Zealand Mental Health Survey Research Team (2006). Prevalence, interference with life and severity of 12 month DSM-IV disorders in Te Rau Hinengaro: the New Zealand Mental Health Survey. Australian and New Zealand Journal of Psychiatry 40, 845–854.CrossRefGoogle ScholarPubMed
Wolter, KM (1985). Introduction to Variance Estimation. Springer-Verlag: New York.Google Scholar
World Bank (2008). World Bank Data and Statistics. World Bank: Washington, DC (http://data.worldbank.org/country).Google Scholar
Zimmermann, P, Wittchen, HU, Höfler, M, Pfister, H, Kessler, RC, Lieb, R (2003). Primary anxiety disorders and the development of subsequent alcohol use disorders: a 4-year community study of adolescents and young adults. Psychological Medicine 33, 1211–1222.CrossRefGoogle ScholarPubMed
Supplementary material: File

Wardenaar supplementary material

Appendix

Download Wardenaar supplementary material(File)
File 129.3 KB