Division of Child and Adolescent Psychiatry, Department of Neuropsychiatry, College of Medicine, Seoul National University, 101 Daehakro, Chongno-Gu, Seoul, Korea.
J Anxiety Disord. 2010 Aug;24(6):629-34. doi: 10.1016/j.janxdis.2010.04.004. Epub 2010 Apr 18.
The aims of this study were to investigate the prevalence, associated co-morbid psychiatric disorders and behavioral/emotional problems associated with the subtypes of specific phobia in children and adolescents.
A total of 2673 randomly selected children and adolescents from Seoul, Korea were assessed using the parent version of the Diagnostic Interview Schedule for Children (DISC-IV) and Children's Behavior Checklist (CBCL). We analyzed differences in psychiatric co-morbidities and CBCL profiles among the subtypes of specific phobia.
The 1-year prevalence of specific phobia was 7.9% (95% CI 7.63-8.17). Animal phobia was associated with anxiety disorder (OR 8.68, 95% CI 1.91-39.51) and oppositional defiant disorder (OR 2.55, 95% CI 1.27-5.12). Nature-environment phobia was associated with anxiety disorder (OR 25.70, 95% CI 6.16-107.10). Blood-injection-injury phobia showed associations with attention-deficit/hyperactivity disorder (ADHD: OR 6.74, 95% CI 2.81-16.15). Subjects with nature-environment phobia scored higher than did controls on the anxious/depressed, social problems, attention problems, and total behavioral problem profiles of the CBCL. Subjects with blood-injection-injury phobia scored significantly higher than did controls on the attention problems, aggressive behaviors, and externalizing problem profiles.
Contrary to animal phobias, nature-environment and blood-injection-injury phobias were associated with various behavioral and emotional problems and approximately correlated to their co-morbid psychiatric disorders. Among these subtypes, significant differences were found in demographic characteristics, co-morbid psychiatric disorders, and emotional/behavioral problems. These findings suggest that distinctive clinical characteristics might be related with different subtypes of specific phobia and clinician must consider psychiatric co-morbidities when treating children & adolescents with specific phobia.
本研究旨在调查儿童和青少年特定恐惧症亚型的流行情况、相关共病精神障碍以及行为/情绪问题。
我们使用儿童诊断性访谈量表(DISC-IV)和儿童行为检查表(CBCL)对韩国首尔 2673 名随机选择的儿童和青少年进行评估。我们分析了特定恐惧症亚型之间精神共病和 CBCL 特征的差异。
特定恐惧症的 1 年患病率为 7.9%(95%CI 7.63-8.17)。动物恐惧症与焦虑障碍(OR 8.68,95%CI 1.91-39.51)和对立违抗性障碍(OR 2.55,95%CI 1.27-5.12)相关。自然环境恐惧症与焦虑障碍相关(OR 25.70,95%CI 6.16-107.10)。血液注射损伤恐惧症与注意力缺陷/多动障碍(ADHD:OR 6.74,95%CI 2.81-16.15)相关。与对照组相比,自然环境恐惧症患者在 CBCL 的焦虑/抑郁、社会问题、注意问题和总行为问题特征上得分较高。与对照组相比,血液注射损伤恐惧症患者在注意问题、攻击性行为和外化问题特征上得分显著较高。
与动物恐惧症相反,自然环境和血液注射损伤恐惧症与各种行为和情绪问题相关,且与共病精神障碍大致相关。在这些亚型中,在人口统计学特征、共病精神障碍和情绪/行为问题方面存在显著差异。这些发现表明,不同的临床特征可能与特定恐惧症的不同亚型有关,临床医生在治疗特定恐惧症的儿童和青少年时必须考虑共病精神障碍。