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

K J Wardenaar¹, C C W Lim², A O Al-Hamzawi³, J Alonso⁴, L H Andrade⁵, C Benjet⁶, B Bunting⁷, G de Girolamo⁸, K Demyttenaere⁹, S E Florescu¹⁰, O Gureje¹¹, T Hisateru¹², C Hu¹³, Y Huang¹⁴, E Karam¹⁵, A Kiejna¹⁶, J P Lepine¹⁷, F Navarro-Mateu¹⁸, M Oakley Browne¹⁹, M Piazza²⁰, J Posada-Villa²¹, M L Ten Have²², Y Torres²³, M Xavier²⁴, Z Zarkov²⁵, R C Kessler²⁶, K M Scott², P de Jonge¹

Affiliations

¹ Department of Psychiatry,University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE),Groningen,The Netherlands.
² Department of Psychological Medicine,Dunedin School of Medicine, University of Otago,Dunedin,New Zealand.
³ College of Medicine, Al-Qadisiya University,Al Diwaniya City,Iraq.
⁴ Health Services Research Unit, Instituto Hospital del Mar de Investigaciones Médicas, Institut de Recerca Hospital del Mar,Barcelona,Spain.
⁵ Department/Institute of Psychiatry,University of São Paulo Medical School,São Paulo,Brazil.
⁶ Department of Epidemiologic and Psychosocial Research,National Institute of Psychiatry Ramón de la Fuente,Mexico City,Mexico.
⁷ Psychology Research Institute, Ulster University,Londonderry,UK.
⁸ IRCCS Centro S. Giovanni di Dio Fatebenefratelli,Brescia,Italy.
⁹ Department of Psychiatry,University Hospital Gasthuisberg, Katholieke Universiteit Leuven,Leuven,Belgium.
¹⁰ National School of Public Health, Management and Professional Development,Bucharest,Romania.
¹¹ Department of Psychiatry,College of Medicine, University of Ibadan, University College Hospital,Ibadan,Nigeria.
¹² National Institute of Mental Health, National Center for Neurology and Psychiatry,Tokyo,Japan.
¹³ Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital,Guangdong Province,People's Republic of China.
¹⁴ Institute of Mental Health, Peking University,Beijing,People's Republic of China.
¹⁵ St George Hospital University Medical Center, Balamand University, Institute for Development, Research,Advocacy,Beirut,Lebanon.
¹⁶ Department of Psychiatry,Wroclaw Medical University,Wroclaw,Poland.
¹⁷ Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris INSERM UMR-S 1144, Paris Diderot University and Paris Descartes University,Paris,France.
¹⁸ 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.
¹⁹ Department of Psychiatry,Monash University,Melbourne, VIC,Australia.
²⁰ National Institute of Health,Lima,Peru.
²¹ El Bosque University,Bogota,Colombia.
²² Trimbos Instituut, Netherlands Institute of Mental Health and Addiction,Utrecht,The Netherlands.
²³ Center for Excellence on Research in Mental Health, CES University,Medellín,Colombia.
²⁴ Nova faculdade ciencias medicas, Faculdade de Ciências Médicas, Universidade Nova de Lisboa,Lisboa,Portugal.
²⁵ Directorate Mental Health, National Center of Public Health and Analyses,Sofia,Bulgaria.
²⁶ Department of Health Care Policy,Harvard University Medical School,Boston, MA,USA.

PMID: 28222820
PMCID: PMC5674525
DOI: 10.1017/S0033291717000174

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

K J Wardenaar et al. Psychol Med. 2017 Jul.

. 2017 Jul;47(10):1744-1760.

doi: 10.1017/S0033291717000174. Epub 2017 Feb 22.

Authors

Affiliations

¹ Department of Psychiatry,University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE),Groningen,The Netherlands.
² Department of Psychological Medicine,Dunedin School of Medicine, University of Otago,Dunedin,New Zealand.
³ College of Medicine, Al-Qadisiya University,Al Diwaniya City,Iraq.
⁴ Health Services Research Unit, Instituto Hospital del Mar de Investigaciones Médicas, Institut de Recerca Hospital del Mar,Barcelona,Spain.
⁵ Department/Institute of Psychiatry,University of São Paulo Medical School,São Paulo,Brazil.
⁶ Department of Epidemiologic and Psychosocial Research,National Institute of Psychiatry Ramón de la Fuente,Mexico City,Mexico.
⁷ Psychology Research Institute, Ulster University,Londonderry,UK.
⁸ IRCCS Centro S. Giovanni di Dio Fatebenefratelli,Brescia,Italy.
⁹ Department of Psychiatry,University Hospital Gasthuisberg, Katholieke Universiteit Leuven,Leuven,Belgium.
¹⁰ National School of Public Health, Management and Professional Development,Bucharest,Romania.
¹¹ Department of Psychiatry,College of Medicine, University of Ibadan, University College Hospital,Ibadan,Nigeria.
¹² National Institute of Mental Health, National Center for Neurology and Psychiatry,Tokyo,Japan.
¹³ Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital,Guangdong Province,People's Republic of China.
¹⁴ Institute of Mental Health, Peking University,Beijing,People's Republic of China.
¹⁵ St George Hospital University Medical Center, Balamand University, Institute for Development, Research,Advocacy,Beirut,Lebanon.
¹⁶ Department of Psychiatry,Wroclaw Medical University,Wroclaw,Poland.
¹⁷ Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris INSERM UMR-S 1144, Paris Diderot University and Paris Descartes University,Paris,France.
¹⁸ 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.
¹⁹ Department of Psychiatry,Monash University,Melbourne, VIC,Australia.
²⁰ National Institute of Health,Lima,Peru.
²¹ El Bosque University,Bogota,Colombia.
²² Trimbos Instituut, Netherlands Institute of Mental Health and Addiction,Utrecht,The Netherlands.
²³ Center for Excellence on Research in Mental Health, CES University,Medellín,Colombia.
²⁴ Nova faculdade ciencias medicas, Faculdade de Ciências Médicas, Universidade Nova de Lisboa,Lisboa,Portugal.
²⁵ Directorate Mental Health, National Center of Public Health and Analyses,Sofia,Bulgaria.
²⁶ Department of Health Care Policy,Harvard University Medical School,Boston, MA,USA.

PMID: 28222820
PMCID: PMC5674525
DOI: 10.1017/S0033291717000174

Erratum in

The cross-national epidemiology of specific phobia in the World Mental Health Surveys - CORRIGENDUM.
Wardenaar KJ, Lim CCW, Al-Hamzawi AO, Alonso J. Wardenaar KJ, et al. Psychol Med. 2018 Apr;48(5):878. doi: 10.1017/S0033291717002975. Epub 2017 Oct 10. Psychol Med. 2018. PMID: 28994357 No abstract available.

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-morbidity; cross-national studies; epidemiology; impairment; specific phobia.

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Conflict of interest statement

Conflict of interest

The other authors report no disclosures.

References

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

Affiliations

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

Authors

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Erratum in

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References

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