Skip to main content
Top
Published in: Social Psychiatry and Psychiatric Epidemiology 4/2008

01-04-2008 | ORIGINAL PAPER

Social phobia and number of social fears, and their association with comorbidity, health-related quality of life and help seeking

A population-based study

Authors: C. Acarturk, MSc, Ron de Graaf, PhD, A. van Straten, PhD, M. ten Have, PhD, P. Cuijpers, PhD

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 4/2008

Login to get access

Abstract

Objectives

Community based data were used to examine the association between social phobia and comorbidity, quality of life and service utilization. In addition, the correlations of the number of social fears with these domains were studied.

Method

Data are from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) (N = 7,076). Social phobia was assessed according to DSM-III-R with the Composite International Diagnostic Interview (CIDI); quality of life was assessed according to the Short-Form-36 Health Survey (SF-36).

Results

The 12-month prevalence of social phobia was 4.8%. Being female, young, low educated, a single parent, living alone, not having a paid job and having a somatic disorder are associated with 12-month social phobia. Mean and median ages of onset of social phobia were 19.1 and 16.0 years, respectively, and mean and median duration were 16.8 and 14.0 years, respectively. 66% of respondents with social phobia had at least one comorbid condition. 12-month social phobia was significantly related to lower quality of life and higher service utilization. The mean number of feared social situations was 2.73 out of the 6 assessed. As the number of social fears increases, comorbidity and service utilization increases, and the quality of life decreases.

Conclusions

These findings suggest as the number of feared social situations increases, the burden of social phobia rises. In other words, like comorbidity or decreased quality of life, the number of social fears is also an important indicator of the severity of social phobia. We conclude that from a public health perspective, mental health care givers should pay attention to the number of social fears in order to check the severity of social phobia.
Literature
1.
go back to reference Akiskal HS, Benazzi F (2006) The DSM-IV and ICD-10 categories of recurrent [major] depressieve and bipolar II disorders: evidence that they lie on a dimensional spectrum. J Affect Disord 92:45–54PubMedCrossRef Akiskal HS, Benazzi F (2006) The DSM-IV and ICD-10 categories of recurrent [major] depressieve and bipolar II disorders: evidence that they lie on a dimensional spectrum. J Affect Disord 92:45–54PubMedCrossRef
2.
go back to reference American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, 3rd edn (revised). APA, Washington American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, 3rd edn (revised). APA, Washington
3.
go back to reference Bijl RV, de Graaf R, Ravelli A, Smit F, Vollebergh WAM (2002) Gender and age-specific first incidence of DSM-III-R psychiatric disorders in the general population: results from the Netherlands mental health survey and incidence study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol 37(8):372–379PubMedCrossRef Bijl RV, de Graaf R, Ravelli A, Smit F, Vollebergh WAM (2002) Gender and age-specific first incidence of DSM-III-R psychiatric disorders in the general population: results from the Netherlands mental health survey and incidence study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol 37(8):372–379PubMedCrossRef
4.
go back to reference Bijl RV, Ravelli A, van Zessen G (1998) Prevalence of psychiatric disorder in the general population: results of The Netherlands mental health survey and incidence study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol 33:587–595PubMedCrossRef Bijl RV, Ravelli A, van Zessen G (1998) Prevalence of psychiatric disorder in the general population: results of The Netherlands mental health survey and incidence study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol 33:587–595PubMedCrossRef
5.
go back to reference Bijl RV, van Zessen G, Ravelli A, de Rijk C, Langendoen Y (1998) The Netherlands mental health survey and incidence study (NEMESIS): objectives and design. Soc Psychiatry Psychiatr Epidemiol 33:581–586PubMedCrossRef Bijl RV, van Zessen G, Ravelli A, de Rijk C, Langendoen Y (1998) The Netherlands mental health survey and incidence study (NEMESIS): objectives and design. Soc Psychiatry Psychiatr Epidemiol 33:581–586PubMedCrossRef
6.
go back to reference Chaleby K (1987) Social phobia in Saudis. Soc Psychiatry Psychiatr Epidemiol 22:167–170 Chaleby K (1987) Social phobia in Saudis. Soc Psychiatry Psychiatr Epidemiol 22:167–170
7.
go back to reference Chartier MJ, Walker JR, Stein MB (2003) Considering comorbidity in social phobia. Soc Psychiatry Psychiatr Epidemiol 38(12):728–734PubMedCrossRef Chartier MJ, Walker JR, Stein MB (2003) Considering comorbidity in social phobia. Soc Psychiatry Psychiatr Epidemiol 38(12):728–734PubMedCrossRef
8.
go back to reference Davidson JRT, Hughes DL, George LK, Blazer DG (1993) The epidemiology of social phobia: findings from the Duke epidemiological catchment area study. Psychol Med 23:709–718PubMedCrossRef Davidson JRT, Hughes DL, George LK, Blazer DG (1993) The epidemiology of social phobia: findings from the Duke epidemiological catchment area study. Psychol Med 23:709–718PubMedCrossRef
9.
go back to reference Fehm L, Pelissolo A, Furmark T, Wittchen HU (2005) Size and burden of social phobia in Europe. Eur Neuropsychopharmacol 15:453–462PubMedCrossRef Fehm L, Pelissolo A, Furmark T, Wittchen HU (2005) Size and burden of social phobia in Europe. Eur Neuropsychopharmacol 15:453–462PubMedCrossRef
10.
11.
go back to reference Furmark T, Tillforts M, Everz PO, Marteinsdottir I, Gefvert O, Fredrikson M (1999) Social phobia in the general population: prevalence and sociodemographic profile. Soc Psychiatry Psychiatr Epidemiol 34:416–424PubMedCrossRef Furmark T, Tillforts M, Everz PO, Marteinsdottir I, Gefvert O, Fredrikson M (1999) Social phobia in the general population: prevalence and sociodemographic profile. Soc Psychiatry Psychiatr Epidemiol 34:416–424PubMedCrossRef
12.
go back to reference Furmark T, Tillfors M, Stattin H, Ekselius L, Fredrikson M (2000) Social phobia subtypes in the general population revealed by cluster analysis. Psychol Med 30:1335–1344PubMedCrossRef Furmark T, Tillfors M, Stattin H, Ekselius L, Fredrikson M (2000) Social phobia subtypes in the general population revealed by cluster analysis. Psychol Med 30:1335–1344PubMedCrossRef
13.
go back to reference Grant BF, Hasin DS, Blanco C et al. (2005) The epidemiology of social anxiety disorder in the United States: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry 66:1351–1361PubMedCrossRef Grant BF, Hasin DS, Blanco C et al. (2005) The epidemiology of social anxiety disorder in the United States: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry 66:1351–1361PubMedCrossRef
14.
go back to reference Hankin BL, Fraley RC, Lahey BB, Waldman ID (2005) Is depression best viewed as a continuum or discrete category? A taxometric analysis of childhood and adolescent depression in a population-based sample. J Abnorm Psychol 114(1):96–110PubMedCrossRef Hankin BL, Fraley RC, Lahey BB, Waldman ID (2005) Is depression best viewed as a continuum or discrete category? A taxometric analysis of childhood and adolescent depression in a population-based sample. J Abnorm Psychol 114(1):96–110PubMedCrossRef
15.
go back to reference Heimberg RG, Stein MB, Hiripi E, Kessler RC (2000) Trends in the prevalence of social phobia in the United States: a synthetic cohort analysis of changes over four decades. Eur Psychiatry 15:29–37PubMedCrossRef Heimberg RG, Stein MB, Hiripi E, Kessler RC (2000) Trends in the prevalence of social phobia in the United States: a synthetic cohort analysis of changes over four decades. Eur Psychiatry 15:29–37PubMedCrossRef
16.
go back to reference Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:593–768PubMedCrossRef Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:593–768PubMedCrossRef
17.
go back to reference Kessler RC, McGonagle KA, Zhao S et al. (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Arch Gen Psychiatry 51:8–19PubMed Kessler RC, McGonagle KA, Zhao S et al. (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Arch Gen Psychiatry 51:8–19PubMed
18.
go back to reference Kessler RC, Stang P, Wittchen HU, Stein M, Walters EE (1999) Lifetime co-morbidities between social phobia and mood disorders in the US national comorbidity survey. Psychol Med 29:555–567PubMedCrossRef Kessler RC, Stang P, Wittchen HU, Stein M, Walters EE (1999) Lifetime co-morbidities between social phobia and mood disorders in the US national comorbidity survey. Psychol Med 29:555–567PubMedCrossRef
19.
go back to reference Kessler RC, Stein MB, Berglund P (1998) Social phobia subtypes in the national comorbidity survey. Am J Psychiatry 155:5 613–619 Kessler RC, Stein MB, Berglund P (1998) Social phobia subtypes in the national comorbidity survey. Am J Psychiatry 155:5 613–619
20.
go back to reference Kringlen E, Torgersen S, Cramer V (2006) Mental illness in a rural area: A Norwegian psychiatric epidemiological study. Soc Psychiatry Psychiatr Epidemiol 41:713–719PubMedCrossRef Kringlen E, Torgersen S, Cramer V (2006) Mental illness in a rural area: A Norwegian psychiatric epidemiological study. Soc Psychiatry Psychiatr Epidemiol 41:713–719PubMedCrossRef
21.
go back to reference Kringlen E, Torgersen S, Cramer V (2001) A Norwegian psychiatric epidemiological study. Am J Psychiatry 158:71091–71098CrossRef Kringlen E, Torgersen S, Cramer V (2001) A Norwegian psychiatric epidemiological study. Am J Psychiatry 158:71091–71098CrossRef
22.
go back to reference Lepine JP, Lellouch J (1995) Classification and epidemiology of social phobia. Eur Arch Psychiatry Clin Neurosci 244:290–296PubMedCrossRef Lepine JP, Lellouch J (1995) Classification and epidemiology of social phobia. Eur Arch Psychiatry Clin Neurosci 244:290–296PubMedCrossRef
23.
go back to reference Magee WJ, Eaton WW, Wittchen HU, McGonagle KA, Kessler RC (1996) Agoraphobia, simple phobia, and social phobia in the national comorbidity survey. Arch Gen Psychiatry 53:159–168PubMed Magee WJ, Eaton WW, Wittchen HU, McGonagle KA, Kessler RC (1996) Agoraphobia, simple phobia, and social phobia in the national comorbidity survey. Arch Gen Psychiatry 53:159–168PubMed
24.
go back to reference Offord DR, Boyle MH, Campbell D et al. (1996) One-year prevalence of psychiatric disorder in Ontarians 15 to 64 years of age. Can J Psychiatry 41:559–561PubMed Offord DR, Boyle MH, Campbell D et al. (1996) One-year prevalence of psychiatric disorder in Ontarians 15 to 64 years of age. Can J Psychiatry 41:559–561PubMed
25.
go back to reference Patel A, Knapp M, Henderson J, Baldwin D (2002) The economic consequences of social phobia. J Affect Disord 68:221–233PubMedCrossRef Patel A, Knapp M, Henderson J, Baldwin D (2002) The economic consequences of social phobia. J Affect Disord 68:221–233PubMedCrossRef
26.
go back to reference Robins LN, Wing J, Wittchen H-U et al. (1988) The composite international diagnostic interview: an epidemiologic instrument suitable for use in conjuction with different diagnostic systems and in different cultures. Arch Gen Psychiatry 45:1069–1077PubMed Robins LN, Wing J, Wittchen H-U et al. (1988) The composite international diagnostic interview: an epidemiologic instrument suitable for use in conjuction with different diagnostic systems and in different cultures. Arch Gen Psychiatry 45:1069–1077PubMed
27.
go back to reference Safren SA, Heimberg RG, Brown EJ, Holle C (1996) Quality of life in social phobia. Depress Anxiety 4:126–133PubMedCrossRef Safren SA, Heimberg RG, Brown EJ, Holle C (1996) Quality of life in social phobia. Depress Anxiety 4:126–133PubMedCrossRef
28.
go back to reference Schneier FR, Johnson J, Hornig CD, Liebowitz MR, Weissman MM (1992) Social phobia: comorbidity and morbidity in an epidemiologic sample. Arch Gen Psychiatry 49:282–288PubMed Schneier FR, Johnson J, Hornig CD, Liebowitz MR, Weissman MM (1992) Social phobia: comorbidity and morbidity in an epidemiologic sample. Arch Gen Psychiatry 49:282–288PubMed
29.
go back to reference Skodol AE, Oldham JM, Bender DS, Dyck IR, Stout RL, Morey LC, Shea MT, Zanarini MC, Sanislow CA, Grilo LM, McGlashan TH, Gunderson JG (2005) Dimensional representations of DSM-IV personality disorders: relationships to functional impairment. Am J Psychiatry 162:1919–1925PubMedCrossRef Skodol AE, Oldham JM, Bender DS, Dyck IR, Stout RL, Morey LC, Shea MT, Zanarini MC, Sanislow CA, Grilo LM, McGlashan TH, Gunderson JG (2005) Dimensional representations of DSM-IV personality disorders: relationships to functional impairment. Am J Psychiatry 162:1919–1925PubMedCrossRef
30.
go back to reference Smeets RMW, Dingemans PMAJ (1993) Composite international diagnostic interview (CIDI), Version 1.1. World Health Organization, Amsterdam Smeets RMW, Dingemans PMAJ (1993) Composite international diagnostic interview (CIDI), Version 1.1. World Health Organization, Amsterdam
31.
go back to reference Spitzer RL, Williams JBW, Gibbon M, First MB (1992) The structured clinical interview for DSM-III-R (SCID) I: history, rationale, and description. Arch Gen Psychiatry 49:624–629PubMed Spitzer RL, Williams JBW, Gibbon M, First MB (1992) The structured clinical interview for DSM-III-R (SCID) I: history, rationale, and description. Arch Gen Psychiatry 49:624–629PubMed
32.
go back to reference Stein MB, Deutsch R (2003) Brief Report: in search of social phobia subtypes: similarity of feared social situations. Depress Anxiety 17:94–97PubMedCrossRef Stein MB, Deutsch R (2003) Brief Report: in search of social phobia subtypes: similarity of feared social situations. Depress Anxiety 17:94–97PubMedCrossRef
33.
go back to reference Stein MB, Kean YM (2000) Disability and quality of life in social phobia: Epidemiological findings. Am J Psychiatry 157:1606–1613PubMedCrossRef Stein MB, Kean YM (2000) Disability and quality of life in social phobia: Epidemiological findings. Am J Psychiatry 157:1606–1613PubMedCrossRef
34.
go back to reference Stein MB, Torgrud LJ, Walker JR (2000) Social phobia symptoms, subtypes, and severity. findings from a community survey. Arch Gen Psychiatry 57:1046–1052PubMedCrossRef Stein MB, Torgrud LJ, Walker JR (2000) Social phobia symptoms, subtypes, and severity. findings from a community survey. Arch Gen Psychiatry 57:1046–1052PubMedCrossRef
35.
go back to reference Vriends N, Becker ES, Meyer A, Michael T, Margraf J (2007) Subtypes of social phobia: are they of any use? J Anxiety Disord 21:59–75PubMedCrossRef Vriends N, Becker ES, Meyer A, Michael T, Margraf J (2007) Subtypes of social phobia: are they of any use? J Anxiety Disord 21:59–75PubMedCrossRef
36.
go back to reference Ware JE, Sherbourne CD (1992) The MOS 36 item short-form health survey (SF36): I. Conceptual framework and item selection. Med Care 30:473–483PubMedCrossRef Ware JE, Sherbourne CD (1992) The MOS 36 item short-form health survey (SF36): I. Conceptual framework and item selection. Med Care 30:473–483PubMedCrossRef
37.
go back to reference Ware JE, Snow KK, Kosinski M, Gandek B (1993) SF-36 health survey, manual & interpretation guide. The Health Institute, New England Medical Center, Boston Ware JE, Snow KK, Kosinski M, Gandek B (1993) SF-36 health survey, manual & interpretation guide. The Health Institute, New England Medical Center, Boston
38.
go back to reference Weissman MM, Bland RC, Canino GJ, Greenwald S, Lee CK, Newman SC, Rubio-Stipec M, Wickramaratne PJ (1996) The cross-national epidemiology of social phobia: a preliminary report. Int Clin Psychopharmacol 11(suppl 3):9–14PubMedCrossRef Weissman MM, Bland RC, Canino GJ, Greenwald S, Lee CK, Newman SC, Rubio-Stipec M, Wickramaratne PJ (1996) The cross-national epidemiology of social phobia: a preliminary report. Int Clin Psychopharmacol 11(suppl 3):9–14PubMedCrossRef
39.
go back to reference Wittchen HU, Fuetsch M, Sonntag H, Muller N, Liebowitz (2000) Disability and quality of life in pure and comorbid social phobia. Findings from a controlled study. Eur Psychiatry 15:46–58 Wittchen HU, Fuetsch M, Sonntag H, Muller N, Liebowitz (2000) Disability and quality of life in pure and comorbid social phobia. Findings from a controlled study. Eur Psychiatry 15:46–58
40.
go back to reference Wittchen H-U, Robins LN, Cottler LB, Sartorius N, Burke JD, Regier DA, Participants in the multicentre WHO/ADAMHA field trials (1991) Cross-cultural feasibility, reliability and sources of variance in the CIDI. Br J Psychiatry 159:645–653PubMed Wittchen H-U, Robins LN, Cottler LB, Sartorius N, Burke JD, Regier DA, Participants in the multicentre WHO/ADAMHA field trials (1991) Cross-cultural feasibility, reliability and sources of variance in the CIDI. Br J Psychiatry 159:645–653PubMed
41.
go back to reference World Health Organization (1990) Composite international diagnostic interview (CIDI), Version 1.0. World Health Organization, Geneva World Health Organization (1990) Composite international diagnostic interview (CIDI), Version 1.0. World Health Organization, Geneva
Metadata
Title
Social phobia and number of social fears, and their association with comorbidity, health-related quality of life and help seeking
A population-based study
Authors
C. Acarturk, MSc
Ron de Graaf, PhD
A. van Straten, PhD
M. ten Have, PhD
P. Cuijpers, PhD
Publication date
01-04-2008
Publisher
D. Steinkopff-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 4/2008
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-008-0309-1

Other articles of this Issue 4/2008

Social Psychiatry and Psychiatric Epidemiology 4/2008 Go to the issue