Roselind Lieb1,2, Marcel Miché1, Andrew T Gloster1, Katja Beesdo-Baum3,4, Andrea H Meyer1, Hans-Ulrich Wittchen2,3. 1. Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Switzerland. 2. Max Planck Institute of Psychiatry, Munich, Germany. 3. Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany. 4. Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany.
Abstract
BACKGROUND: The role of specific phobia as a potentially important psychopathological precursor condition to more severe mental disorders is understudied. We examined the prospective-longitudinal association of early childhood/adolescent phobia with subsequent mental disorders and the proportion of outcome disease incidence attributable to specific phobia simultaneously for a broad range of disorders. METHODS: N = 2210 14- to 24-year-old community subjects were followed up for 10 years. DSM-IV-specific phobia as exposure and a broad range of DSM-IV mental disorders as outcomes were assessed with the DSM-IV/M-CIDI. Logistic regressions, adjusting for confounders, were used to estimate the associations of specific phobia with the subsequent onset of outcome disorders. RESULTS: Baseline specific phobia predicted the subsequent first onset of anxiety disorders [panic disorder: risk ratio (RR) = 4.38, 95% confidence interval (2.34, 8.21); generalized anxiety disorder: RR = 4.10 (2.19, 7.69); posttraumatic stress disorder: RR = 2.15 (1.13, 4.10); obsessive-compulsive disorder: RR = 3.79 (1.63, 8.82)], affective disorders [major depression: RR = 1.54 (1.16, 2.03); bipolar disorder: RR = 2.20 (1.10, 4.41); dysthymia: RR = 2.75 (1.48, 5.11)], pain disorder: RR = 1.52 (1.14, 2.02), and eating disorders: RR = 2.27 (1.14, 4.51). Population attributable fractions (PAFs; i.e., proportion of outcome disease incidence in the total population attributable to specific phobia) were highest for panic disorder (PAF = 33.93), generalized anxiety disorder (PAF = 32.3), and obsessive-compulsive disorders (PAF = 30.2). CONCLUSION: This study provides strong evidence that specific phobia is an early onset disorder predicting the subsequent onset of a range of disorders. Future studies should examine the underlying mechanisms and the potential of using specific phobia as a target for prevention of subsequent psychopathology.
BACKGROUND: The role of specific phobia as a potentially important psychopathological precursor condition to more severe mental disorders is understudied. We examined the prospective-longitudinal association of early childhood/adolescent phobia with subsequent mental disorders and the proportion of outcome disease incidence attributable to specific phobia simultaneously for a broad range of disorders. METHODS: N = 2210 14- to 24-year-old community subjects were followed up for 10 years. DSM-IV-specific phobia as exposure and a broad range of DSM-IV mental disorders as outcomes were assessed with the DSM-IV/M-CIDI. Logistic regressions, adjusting for confounders, were used to estimate the associations of specific phobia with the subsequent onset of outcome disorders. RESULTS: Baseline specific phobia predicted the subsequent first onset of anxiety disorders [panic disorder: risk ratio (RR) = 4.38, 95% confidence interval (2.34, 8.21); generalized anxiety disorder: RR = 4.10 (2.19, 7.69); posttraumatic stress disorder: RR = 2.15 (1.13, 4.10); obsessive-compulsive disorder: RR = 3.79 (1.63, 8.82)], affective disorders [major depression: RR = 1.54 (1.16, 2.03); bipolar disorder: RR = 2.20 (1.10, 4.41); dysthymia: RR = 2.75 (1.48, 5.11)], pain disorder: RR = 1.52 (1.14, 2.02), and eating disorders: RR = 2.27 (1.14, 4.51). Population attributable fractions (PAFs; i.e., proportion of outcome disease incidence in the total population attributable to specific phobia) were highest for panic disorder (PAF = 33.93), generalized anxiety disorder (PAF = 32.3), and obsessive-compulsive disorders (PAF = 30.2). CONCLUSION: This study provides strong evidence that specific phobia is an early onset disorder predicting the subsequent onset of a range of disorders. Future studies should examine the underlying mechanisms and the potential of using specific phobia as a target for prevention of subsequent psychopathology.
Authors: 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; S E Florescu; O Gureje; T Hisateru; C Hu; Y Huang; E Karam; A Kiejna; J P Lepine; F Navarro-Mateu; M Oakley Browne; M Piazza; J Posada-Villa; M L Ten Have; Y Torres; M Xavier; Z Zarkov; R C Kessler; K M Scott; P de Jonge Journal: Psychol Med Date: 2017-02-22 Impact factor: 7.723
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Authors: Ymkje Anna de Vries; Ali Al-Hamzawi; Jordi Alonso; Guilherme Borges; Ronny Bruffaerts; Brendan Bunting; José Miguel Caldas-de-Almeida; Alfredo H Cia; Giovanni De Girolamo; Rumyana V Dinolova; Oluyomi Esan; Silvia Florescu; Oye Gureje; Josep Maria Haro; Chiyi Hu; Elie G Karam; Aimee Karam; Norito Kawakami; Andrzej Kiejna; Viviane Kovess-Masfety; Sing Lee; Zeina Mneimneh; Fernando Navarro-Mateu; Marina Piazza; Kate Scott; Margreet Ten Have; Yolanda Torres; Maria Carmen Viana; Ronald C Kessler; Peter de Jonge Journal: BMC Med Date: 2019-05-24 Impact factor: 8.775
Authors: Ymkje Anna de Vries; Ali Al-Hamzawi; Jordi Alonso; Laura Helena Andrade; Corina Benjet; Ronny Bruffaerts; Brendan Bunting; Giovanni de Girolamo; Silvia Florescu; Oye Gureje; Josep Maria Haro; Aimee Karam; Elie G Karam; Norito Kawakami; Viviane Kovess-Masfety; Sing Lee; Zeina Mneimneh; Fernando Navarro-Mateu; Akin Ojagbemi; José Posada-Villa; Kate Scott; Juan Carlos Stagnaro; Yolanda Torres; Miguel Xavier; Zahari N Zarkov; Ronald C Kessler; Peter de Jonge Journal: Psychol Med Date: 2020-11-10 Impact factor: 10.592