Hostname: page-component-848d4c4894-m9kch Total loading time: 0 Render date: 2024-05-19T18:57:21.928Z Has data issue: false hasContentIssue false
  • English
  • Français

Epidemiology of social phobia: a clinical approach

Published online by Cambridge University Press:  16 April 2020

C. Faravelli ,
T. Zucchi ,
B. Viviani ,
R. Salmoria ,
A. Perone ,
A. Paionni ,
A. Scarpato ,
D. Vigliaturo ,
S. Rosi  and
D. D’adamo
...Show all authors
C. Faravelli
Affiliation:
Psychiatric Unit, Department of Neurologic and Psychiatric Sciences, University of Florence, Policlinico Careggi, Viale Morgagni 85, 50134Florence, Italy
T. Zucchi
Affiliation:
Psychiatric Unit, Department of Neurologic and Psychiatric Sciences, University of Florence, Policlinico Careggi, Viale Morgagni 85, 50134Florence, Italy
B. Viviani
Affiliation:
Psychiatric Unit, Department of Neurologic and Psychiatric Sciences, University of Florence, Policlinico Careggi, Viale Morgagni 85, 50134Florence, Italy
R. Salmoria
Affiliation:
Psychiatric Unit, Department of Neurologic and Psychiatric Sciences, University of Florence, Policlinico Careggi, Viale Morgagni 85, 50134Florence, Italy
A. Perone
Affiliation:
Psychiatric Unit, Department of Neurologic and Psychiatric Sciences, University of Florence, Policlinico Careggi, Viale Morgagni 85, 50134Florence, Italy
A. Paionni
Affiliation:
Psychiatric Unit, Department of Neurologic and Psychiatric Sciences, University of Florence, Policlinico Careggi, Viale Morgagni 85, 50134Florence, Italy
A. Scarpato
Affiliation:
Psychiatric Unit, Department of Neurologic and Psychiatric Sciences, University of Florence, Policlinico Careggi, Viale Morgagni 85, 50134Florence, Italy
D. Vigliaturo
Affiliation:
Psychiatric Unit, Department of Neurologic and Psychiatric Sciences, University of Florence, Policlinico Careggi, Viale Morgagni 85, 50134Florence, Italy
S. Rosi
Affiliation:
Psychiatric Unit, Department of Neurologic and Psychiatric Sciences, University of Florence, Policlinico Careggi, Viale Morgagni 85, 50134Florence, Italy
D. D’adamo
Affiliation:
Psychiatric Unit, Department of Neurologic and Psychiatric Sciences, University of Florence, Policlinico Careggi, Viale Morgagni 85, 50134Florence, Italy
D. Bartolozzi
Affiliation:
Psychiatric Unit, Department of Neurologic and Psychiatric Sciences, University of Florence, Policlinico Careggi, Viale Morgagni 85, 50134Florence, Italy
C. Cecchi
Affiliation:
Psychiatric Unit, Department of Neurologic and Psychiatric Sciences, University of Florence, Policlinico Careggi, Viale Morgagni 85, 50134Florence, Italy
L. Abrardi
Affiliation:
Psychiatric Unit, Department of Neurologic and Psychiatric Sciences, University of Florence, Policlinico Careggi, Viale Morgagni 85, 50134Florence, Italy
Get access

Summary

The recent epidemiologic studies report extremely varied rates for social phobia (SP). One of the reasons for this may be the difficulty in diagnosing SP, the boundaries of which are uncertain. A community survey was carried out using doctors with experience in clinical psychiatry as interviewers, and a clinical diagnostic instrument. Two thousand three hundred and fifty-five people (out of the 2,500 randomly selected from the population) living in Sesto Fiorentino, a suburb of Florence, Italy, were interviewed by their own general practitioner, using the MINI plus six additional questions. Six hundred and ten of the 623 subjects that were found positive for any form of psychopathology at the screening interview, and 57 negative subjects, were re-interviewed by residents in psychiatry using the Florence Psychiatric Interview (FPI). The FPI is a validated composite instrument that has the format of a structured clinical research record. It was found that 6.58% of subjects showed social anxiety not attributable to other psychiatric or medical conditions during their life. Social or occupational impairments meeting DSM-IV diagnostic requirements for SP was detected in 76 subjects (lifetime prevalence = 3.27%). Correction for age raises the lifetime expected prevalence to 4%. Sex ratio was approximately (F:M) 2:1. The most common fear was speaking in public (89.4%), followed by entering a room occupied by others (63.1%) and meeting with strangers (47.3%). Eighty-six point nine percent of subjects with SP complained of more than one fear. The mean age of onset (when the subjects first fully met DSM-IV criteria for SP) was 28.8 years, but the first symptoms of SP usually occurred much earlier, with a mean age of onset at 15.5 years. Ninety-two percent of cases with SP also showed at least one other co-morbid psychiatric disorder during their life. Lifetime prevalence of avoidant personality disorder (APD) was 3.6%. Forty-two point nine percent of cases with SP also had APD, whereas 37.9% of cases with APD developed SP.

Keywords

avoidanceco-morbiditycostepidemiologysocial anxietysocial phobia
Type
Original article
Information
European Psychiatry , Volume 15 , Issue 1 , 2000 , pp. 17 - 24
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2000

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

Angst, J.Dobler-Mikola, A.The Zurich Study. V. Anxiety and phobia in young adults. Eur Arch Psychiatry Neurol Sci 1985; 235: 171–17810.1007/BF00380989CrossRefGoogle ScholarPubMed
American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. 4th ed. 1994 APA: Washington DCGoogle Scholar
Arillo Crespo, A.Aguinaga Ontoso, I.Guillen Grima, F.Prevelencia de enfermedades mentales en mujeres de una zona urbana. Aten Primaria 1998; 21: 265–269Google Scholar
Beidel, D.C.Social anxiety disorder: etiology and early clinical presentation. J Clin Psychiatry 59 Suppl 17 1998 27–32Google ScholarPubMed
Carta, M.G.Rudas, N.Uno studio sul benessere psicologico degli emigrati sardi a Parigi a confronto con i sardi residenti in Sardegna e con i parigini.Progressi in psichiatria transculturale. Parte IV. 1998 CUEC: Cagliari 97–118Google Scholar
Davidson, J.R.T.Hughes, D.L.George, L.K.Blazer, D.G.(1993) The epidemiology of social phobia: findings from the Duke Epidemiological Catchment Area Study. Psychol M 1993; 23: 709–718CrossRefGoogle ScholarPubMed
Degonda, M.Angst, J.The Zurich Study. XX. Social phobia and agoraphobia. Eur Arch Psychiatry Clin Neurosci 1993; 243: 95–102CrossRefGoogle ScholarPubMed
Faravelli, C.Guerrini, D.E.G.L’innocenti, B.Giandinelli, L.Epidemiology of anxiety disorders in Florence Acta Psychiatr Scand 1989; 79: 308–312CrossRefGoogle ScholarPubMed
Faravelli, C.Bartolozzi, D.Paionni, A.Cimminiello, L.Fabbri, C.DiMatteo, C. et al. The Florence Psychiatric Interview: construction and preliminary validation Psychiatr Networks 1-2 1998 78–91Google Scholar
Herbert, J.D.Hope, D.A.Bellack, A.S.Validity of the distinction between generalized social phobia and avoidant personality disorders. J Abnorm Psychol 1992; 101: 332–339CrossRefGoogle Scholar
Holt, C.S.Heinberg, R.G.Hope, D.A.Avoidant personality disorder and the generalized subtype of social phobia. J Abnorm Psychol 1992; 101: 318–325CrossRefGoogle ScholarPubMed
Judd, L.L.Social phobia: a clinical overview. J Clin Psychiatry 55 Suppl 6 1994 5–9Google ScholarPubMed
Kessler, R.C.McGonagle, K.A.Zhao, S.Nelson, C.B.Hughes, M.Eshleman, S. et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Comorbidity Survey. Arch Gen Psychiatry 1994; 51: 8–19CrossRefGoogle ScholarPubMed
Kessler, R.C.Stein, M.B.Berglund, P.Social phobia subtypes in the National Comorbidity Survey. Am J Psychiatry 1998; 155: 613–619CrossRefGoogle ScholarPubMed
Lecrubier, Y.Sheehan, D.V.Weiller, E.Amorin, P.Bonora, I.Harnett Sheehan, K. et al. The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. Eur Psychiatry 1997; 12: 224–231CrossRefGoogle Scholar
Lépine, J.P.Lellouch, J.Diagnosis and epidemiology of agoraphobia and social phobia. Clin Neuropharmacol 18 Suppl 2 1995 S15–S26CrossRefGoogle Scholar
Lindal, E.Stefansson, J.G.The lifetime prevalence of anxiety disorders in Iceland as estimated by the US National Institute of Mental Health Diagnostic Interview Schedule. Acta Psychiatr Scand 1993; 88: 29–34CrossRefGoogle ScholarPubMed
Magee, W.J.Eaton, W.W.Wittchen, H.U.McGonable, K.A.Kessler, R.C.Agoraphobia, simple phobia and social phobia in the National Comorbidity Survey. Arch Gen Psychiatry 1996; 53: 159–168CrossRefGoogle ScholarPubMed
Marks, I.The classification of phobic disorders. Br J Psychiatry 1995; 116: 377–386CrossRefGoogle Scholar
Pelissolo, A.Lépine, J.P.Social phobia: historical and conceptual perspectives. Encephale 1995; 21: 15–24Google ScholarPubMed
Pini, S.Cassano, G.B.Simonini, E.Savino, M.Russo, A.Montgomery, S.A.Prevalence of anxiety disorders comorbidity in bipolar depression, unipolar depression and dysthymia. J Affect Disord 1997; 42: 145–15310.1016/S0165-0327(96)01405-XCrossRefGoogle ScholarPubMed
Schneier, F.R.Johnson, J.Horning, C.D.Liebowitz, M.R.Weissman, M.M.Social phobia: comorbidity and morbidity in an epidemiologic sample. Arch Gen Psychiatry 1992; 49: 282–288CrossRefGoogle Scholar
Sheehan, D.V.Lecrubier, Y.Sheehan, K.H.Janavs, J.Weiller, E.Keskiner, A. et al. The validity of the Mini International Neuropsychiatric Interview (MINI) according to the SCID-P and its reliability. Eur Psychiatry 1997; 12: 232–241CrossRefGoogle Scholar
Stein, M.B.Tancer, M.E.Gelernter, C.D.Vittore, B.J.Uhde, T.W.Major depression in patients with social phobia. Am J Psychiatr 1990; 147: 637–639Google ScholarPubMed
Stein, M.B.Walker, J.R.Forde, D.R.Public speaking fears in a community sample: prevalence, impact on functioning, and diagnostic classification. Arch Gen Psychiatry 1996; 53: 169–174CrossRefGoogle Scholar
Thyer, B.A.Parrish, R.T.Curtis, G.C.Nesse, R.M.Cameron, O.G.Ages of onset of DSM-III anxiety disorders. Compr Psychiatry 1985; 26: 113–121CrossRefGoogle ScholarPubMed
Turner, S.M.Beidel, D.C.Townsley, R.M.Social phobia: a comparison of specific and generalized subtypes and avoidant personality disorder. J Abnorm Psychol 1992; 101: 326–331CrossRefGoogle ScholarPubMed
Wacker, H.R.Mulleians, R.Klein, K.H.Battegay, R.Identification of cases of anxiety disorders and affective disorders in the community according to ICD/10 and DSM-III-R by using the composite international diagnostic interview (CIDI). Int J Methods Psychiatr Res 1992; 2: 91–100Google Scholar
Weiller, E.Bisserbe, J.C.Boyer, P.Lépine, J.P.Lecrubier, Y.Social phobia in general health care: an unrecognised undertreated disabling disorder. Br J Psychiatry 1996; 168: 169–174CrossRefGoogle ScholarPubMed
Weiller, E.Bisserbe, J.C.Maier, W.Lecrubier, Y.Prevalence and recognition of anxiety syndromes in five European primary care settings. A report from the WHO study on Psychological Problems in General Health Care. Br J Psychiatry 34 Suppl 1998 18–23CrossRefGoogle Scholar
Wittchen, H.U.Stein, M.B.Kessler, R.C.Social fears and social phobia in a community sample of adolescents and young adults: prevalence, risk factors and co-morbidity. Psychol M 1999; 29: 309–323CrossRefGoogle Scholar
Weissman, M.M.Bland, R.C.Canino, G.J.Greenwald, S.Lee, C.K.Newman, S.C. et al. The cross-national epidemiology of social phobia: a preliminary report. Int Clin Psychopharmacol 11 Suppl 3 1996 9–1410.1097/00004850-199606003-00003CrossRefGoogle ScholarPubMed
Wittchen, H.U.Essau, C.A.Zerssen, D.VonKrieg, D.Zaudig, M.Lifetime and six-month prevalence of mental disorders in the Munich follow-up study. Eur Arch Psychiatry Clin Neurosci 1992; 241: 247–258CrossRefGoogle ScholarPubMed
Wittchen, H.U.Nelson, C.B.Lachner, G.Prevalence of mental disorders and psychosocial impairments in adolescents and young adults. Psychol M 1998; 28: 109–126CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.