Wardenaar K J, Lim C C W, Al-Hamzawi A O, Alonso J, Andrade L H, Benjet C, Bunting B, de Girolamo G, Demyttenaere K, Florescu S E, Gureje O, Hisateru T, Hu C, Huang Y, Karam E, Kiejna A, Lepine J P, Navarro-Mateu F, Oakley Browne M, Piazza M, Posada-Villa J, Ten Have M L, Torres Y, Xavier M, Zarkov Z, Kessler R C, Scott K M, de Jonge P
Department of Psychiatry,University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE),Groningen,The Netherlands.
Department of Psychological Medicine,Dunedin School of Medicine, University of Otago,Dunedin,New Zealand.
Psychol Med. 2017 Jul;47(10):1744-1760. doi: 10.1017/S0033291717000174. Epub 2017 Feb 22.
Although specific phobia is highly prevalent, associated with impairment, and an important risk factor for the development of other mental disorders, cross-national epidemiological data are scarce, especially from low- and middle-income countries. This paper presents epidemiological data from 22 low-, lower-middle-, upper-middle- and high-income countries.
Data came from 25 representative population-based surveys conducted in 22 countries (2001-2011) as part of the World Health Organization World Mental Health Surveys initiative (n = 124 902). The presence of specific phobia as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition was evaluated using the World Health Organization Composite International Diagnostic Interview.
The cross-national lifetime and 12-month prevalence rates of specific phobia were, respectively, 7.4% and 5.5%, being higher in females (9.8 and 7.7%) than in males (4.9% and 3.3%) and higher in high- and higher-middle-income countries than in low-/lower-middle-income countries. The median age of onset was young (8 years). Of the 12-month patients, 18.7% reported severe role impairment (13.3-21.9% across income groups) and 23.1% reported any treatment (9.6-30.1% across income groups). Lifetime co-morbidity was observed in 60.5% of those with lifetime specific phobia, with the onset of specific phobia preceding the other disorder in most cases (72.6%). Interestingly, rates of impairment, treatment use and co-morbidity increased with the number of fear subtypes.
Specific phobia is common and associated with impairment in a considerable percentage of cases. Importantly, specific phobia often precedes the onset of other mental disorders, making it a possible early-life indicator of psychopathology vulnerability.
尽管特定恐惧症非常普遍，与功能损害相关，且是其他精神障碍发生的重要风险因素，但跨国流行病学数据稀缺，尤其是来自低收入和中等收入国家的数据。本文呈现了来自22个低收入、中低收入、中高收入和高收入国家的流行病学数据。
数据来自于2001年至2011年在22个国家进行的25项具有代表性的基于人群的调查，这些调查是世界卫生组织世界心理健康调查倡议的一部分（n = 124902）。使用世界卫生组织综合国际诊断访谈评估《精神障碍诊断与统计手册》第四版所定义的特定恐惧症的存在情况。
特定恐惧症的跨国终生患病率和12个月患病率分别为7.4%和5.5%，女性（9.8%和7.7%）高于男性（4.9%和3.3%），高收入和中高收入国家高于低收入/中低收入国家。发病的中位年龄较小（8岁）。在12个月内患病的患者中，18.7%报告有严重的角色功能损害（各收入组为13.3% - 21.9%），23.1%报告接受过任何治疗（各收入组为9.6% - 30.1%）。在有终生特定恐惧症的患者中，60.5%观察到终生共病，在大多数情况下（72.6%）特定恐惧症的发病先于其他障碍。有趣的是，功能损害率、治疗使用率和共病率随着恐惧亚型的数量增加而上升。
特定恐惧症很常见，且在相当比例的病例中与功能损害相关。重要的是，特定恐惧症通常先于其他精神障碍发病，使其成为心理病理学易感性的一个可能的早期生活指标。
