Davidson J R, Hughes D L, George L K, Blazer D G
Department of Psychiatry, Duke University Medical Center, Durham, NC 27710.
Psychol Med. 1993 Aug;23(3):709-18. doi: 10.1017/s0033291700025484.
Social phobia was studied in a North Carolina community, using DSM-III criteria. Two kinds of comparison were made: social phobia v. non-social phobia, and comorbid social phobia v. non-comorbid social phobia. Six-month and lifetime prevalence rates were 2.7 and 3.8% respectively. Social phobia had an early onset, lasted a long time and rarely recovered. Predictors of good outcome recovery in a logistic regression analysis were onset of phobia after age 11, absence of psychiatric comorbidity and greater education. The disorder was often missed in medical consultation. Increased rates of psychiatric comorbidity existed, especially for other anxiety disorders and for schizophrenia/schizophreniform disorder. There was increased risk of neurological disorder. Social phobia was also associated with an increased rate of suicide attempts, antisocial behaviour and impaired school performance during adolescence, impaired medical health, increased health-seeking behaviour, poor employment performance, reduced social interaction and impaired social support. Comorbidity accounted for some, but not all observed differences.
采用《精神疾病诊断与统计手册》第三版标准，在北卡罗来纳州的一个社区对社交恐惧症进行了研究。进行了两种比较：社交恐惧症与非社交恐惧症，以及共病社交恐惧症与非共病社交恐惧症。六个月和终生患病率分别为2.7%和3.8%。社交恐惧症起病早，病程长，很少康复。逻辑回归分析中良好结局恢复的预测因素为11岁以后起病、无精神疾病共病以及受教育程度较高。该疾病在医疗咨询中常被漏诊。存在精神疾病共病率增加的情况，尤其是其他焦虑症和精神分裂症/精神分裂症样障碍。存在神经系统疾病风险增加的情况。社交恐惧症还与自杀未遂率增加、反社会行为以及青少年期学业成绩受损、身体健康受损、就医行为增加、就业表现不佳、社交互动减少和社会支持受损有关。共病解释了部分但并非所有观察到的差异。
