Childhood generalized specific phobia as an early marker of internalizing psychopathology across the lifespan: results from the World Mental Health Surveys.
Por:
de Vries YA, Al-Hamzawi A, Alonso J, Borges G, Bruffaerts R, Bunting B, Caldas-de-Almeida JM, Cia AH, De Girolamo G, Dinolova RV, Esan O, Florescu S, Gureje O, Haro JM, Hu C, Karam EG, Karam A, Kawakami N, Kiejna A, Kovess-Masfety V, Lee S, Mneimneh Z, Navarro-Mateu F, Piazza M, Scott K, Ten Have M, Torres Y, Viana MC, Kessler RC, de Jonge P and WHO World Mental Health Survey Collaborators
Publicada:
24 may 2019
Ahead of Print:
24 may 2019
Categoría:
Medicine (miscellaneous)
Resumen:
BACKGROUND: Specific phobia (SP) is a relatively common disorder associated with high levels of psychiatric comorbidity. Because of its early onset, SP may be a useful early marker of internalizing psychopathology, especially if generalized to multiple situations. This study aimed to evaluate the association of childhood generalized SP with comorbid internalizing disorders. METHODS: We conducted retrospective analyses of the cross-sectional population-based World Mental Health Surveys using the Composite International Diagnostic Interview. Outcomes were lifetime prevalence, age of onset, and persistence of internalizing disorders; past-month disability; lifetime suicidality; and 12-month serious mental illness. Logistic and linear regressions were used to assess the association of these outcomes with the number of subtypes of childhood-onset (< 13 years) SP. RESULTS: Among 123,628 respondents from 25 countries, retrospectively reported prevalence of childhood SP was 5.9%, 56% of whom reported one, 25% two, 10% three, and 8% four or more subtypes. Lifetime prevalence of internalizing disorders increased from 18.2% among those without childhood SP to 46.3% among those with one and 75.6% those with 4+ subtypes (OR = 2.4, 95% CI 2.3-2.5, p < 0.001). Twelve-month persistence of lifetime internalizing comorbidity at interview increased from 47.9% among those without childhood SP to 59.0% and 79.1% among those with 1 and 4+ subtypes (OR = 1.4, 95% CI 1.4-1.5, p < 0.001). Respondents with 4+ subtypes also reported significantly more disability (3.5 days out of role in the past month) than those without childhood SP (1.1 days) or with only 1 subtype (1.8 days) (B = 0.56, SE 0.06, p < 0.001) and a much higher rate of lifetime suicide attempts (16.8%) than those without childhood SP (2.0%) or with only 1 subtype (6.5%) (OR = 1.7, 95% CI 1.7-1.8, p < 0.001). CONCLUSIONS: This large international study shows that childhood-onset generalized SP is related to adverse outcomes in the internalizing domain throughout the life course. Comorbidity, persistence, and severity of internalizing disorders all increased with the number of childhood SP subtypes. Although our study cannot establish whether SP is causally associated with these poor outcomes or whether other factors, such as a shared underlying vulnerability, explain the association, our findings clearly show that childhood generalized SP identifies an important target group for early intervention.
Filiaciones:
de Vries YA:
Faculty of Behavioural and Social Sciences, Department of Developmental Psychology, University of Groningen, Groningen, the Netherlands.
Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Al-Hamzawi A:
College of Medicine, Al-Qadisiya University, Diwaniya governorate, Iraq
Alonso J:
Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
Pompeu Fabra University (UPF), Barcelona, Spain
Borges G:
National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
Bruffaerts R:
Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
Bunting B:
School of Psychology, Ulster University, Londonderry, UK
Caldas-de-Almeida JM:
Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), NOVA Medical School / Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
Cia AH:
Anxiety Clinic and Research Center, Buenos Aires, Argentina
De Girolamo G:
IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
Dinolova RV:
National Center of Public Health and Analyses, Sofia, Bulgaria
Esan O:
Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
Florescu S:
National School of Public Health, Management and Development, Bucharest, Romania
Gureje O:
Department of Psychiatry, University College Hospital, Ibadan, Nigeria
Haro JM:
Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
Department of Psychology, College of Education, King Saud University, Riyadh, Saudi Arabia
Hu C:
Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Shenzhen, China
Karam EG:
Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon
Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
Karam A:
Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
Kawakami N:
National Institute of Mental Health, National Center for Neurology and Psychiatry, Kodaira, Tokyo, Japan
Kiejna A:
Wroclaw Medical University, Wroclaw, Poland
University of Lower Silesia, Wroclaw, Poland
Kovess-Masfety V:
Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057, Paris Descartes University, Paris, France
Lee S:
Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
Mneimneh Z:
Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
Navarro-Mateu F:
UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud, IMIB-Arrixaca, CIBERESP-Murcia, Murcia, Spain
Instituto Murciano de Investigación Biosanitaria (IMIB) Virgen de la Arrixaca, Murcia, Spain
Centro de Investigación Biomédica en ERed en Epidemiología y Salud Pública (CIBERESP), Murcia, Spain
Piazza M:
Instituto Nacional de Salud, Lima, Peru
Universidad Cayetano Heredia, Lima, Peru
Scott K:
Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
Ten Have M:
Trimbos Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
Torres Y:
Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia
Viana MC:
Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitoria, Brazil
Kessler RC:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
de Jonge P:
Faculty of Behavioural and Social Sciences, Department of Developmental Psychology, University of Groningen, Groningen, the Netherlands
Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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