ausblenden:
Schlagwörter:
anxiety/anxiety disorders, bipolar disorder, depression, epidemiology, gad/generalized anxiety disorder, mood disorders, substance use disorders
Zusammenfassung:
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 =
22.9), 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. (C) 2016 Wiley Periodicals, Inc.
