Epidemiological and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Calzada México-Xochimilco 101, Col San Lorenzo Huipulco, México DF, Mexico 14370.
J Clin Psychiatry. 2012 Feb;73(2):152-8. doi: 10.4088/JCP.11m07442.
Specific phobia is among the most common disorders in the general adolescent population, but also among the least studied. The objectives of this study were to estimate the prevalence of specific fears among adolescents, the proportion of those with fears who meet criteria for specific phobia, and the proportion who recognize their fears as excessive and to identify comorbidity with other disorders and factors associated with severity and treatment.
3,005 youth aged 12 to 17 years participated in the Mexican Adolescent Mental Health Survey, a stratified multistage probability sample representative of adolescents living in Mexico City in 2005. Fears, specific phobia, and 20 other DSM-IV psychiatric disorders were evaluated with the adolescent computerized version of the World Mental Health Composite International Diagnostic Interview, administered by trained lay interviewers in the participants' homes. Descriptive, logistic regression, and discrete-time survival analyses were employed.
Most adolescents reported at least 1 fear (76.5%); 36.5% of those met lifetime criteria for specific phobia, and 27.3% met criteria in the prior 12 months. Blood-injection-injury and animal fears were the most common types. Females were more likely to report any fear, to have more fear types, and to meet diagnostic criteria. Increased numbers of fears were associated with increased odds of meeting specific phobia criteria and with increased impairment. Among teens with specific phobia, 71.3% recognized their fear as excessive, 9.7% to 12.3% reported severe impairment, and only 6.5% had received treatment. Severity of impairment and comorbid disorders were associated with treatment seeking.
The large percentage of adolescents meeting diagnostic criteria coupled with the low proportion with serious impairment suggests that current diagnostic thresholds may be too low or not developmentally sensitive. Future research should address the nature of impairment for adolescents with specific phobia. Early detection and timely treatment are important given that specific phobia is persistent and highly comorbid and that few individuals seek treatment.
特定恐惧症是普通青少年群体中最常见的障碍之一，但也是研究最少的障碍之一。本研究的目的是估计青少年特定恐惧的患病率，确定符合特定恐惧症诊断标准的恐惧人群比例，以及认识到恐惧过度的人群比例，并确定与严重程度和治疗相关的其他障碍和因素的共病情况。
3005 名 12 至 17 岁的青少年参加了 2005 年在墨西哥城进行的墨西哥青少年心理健康调查，这是一个分层多阶段概率样本，代表了居住在墨西哥城的青少年。使用经过培训的非专业访谈员在参与者家中对他们进行青少年计算机版的《世界精神卫生综合国际诊断访谈》评估，以评估恐惧、特定恐惧症和 20 种其他 DSM-IV 精神障碍。采用描述性、逻辑回归和离散时间生存分析。
大多数青少年报告了至少一种恐惧（76.5%）；36.5%的人符合特定恐惧症的终生诊断标准，27.3%的人在过去 12 个月符合标准。血液注射伤害和动物恐惧是最常见的类型。女性更有可能报告任何恐惧，有更多的恐惧类型，并符合诊断标准。恐惧数量的增加与符合特定恐惧症标准的几率增加以及与损伤增加相关。在特定恐惧症患者中，71.3%的人认为他们的恐惧是过度的，9.7%至 12.3%的人报告严重受损，只有 6.5%的人接受了治疗。严重程度的损伤和共病障碍与寻求治疗有关。
符合诊断标准的青少年比例很大，而严重损伤的比例很低，这表明目前的诊断标准可能过低或不符合发展敏感。未来的研究应该解决特定恐惧症青少年的损伤性质。鉴于特定恐惧症是持续存在的，并且高度共病，而且很少有人寻求治疗，因此早期发现和及时治疗非常重要。
