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The Zurich study

XX. Social Phobia and agoraphobia

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Summary

The problems in association with agoraphobia and social phobia were examined in an 11-year prospective longitudinal study of a Swiss cohort of young adults. The weighted prevalence rates according to DSM-III were 2.9% for agoraphobia and 3.8% for social phobia. Although the problem of agoraphobia was greater in females, an equal sex ratio was observed for social phobia. There was a significant degree of comorbility between the two subtypes of phobia, with females exhibiting a significantly greater frequency of co-occurrence of both disorders than males. The course of the two disorders was quite similar. In general, subjects with both disorders reported a more severe course. Assessment of comorbidity of phobias and other disorders revealed that agoraphobia was most significantly associated with extended neurasthenia, sexual problems, and the consumption of cannabis. On the other hand, social phobia was associated with other disorders than agoraphobia, with the strongest associations emerging for simple phobia, extended insomnia, and alcohol abuse. These findings support the validity of the distinction between different subtypes of phobia. The longitudinal analysis revealed that also phobia in general was not stable at the diagnostic level phobic symptoms were quite persistent across time.

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References

  • Ameringen Van M, Mancini C, Styan G, Donison D (1991) Relationship of social phobia with other psychiatric illness. J Affect Disord 21:93–99

    Google Scholar 

  • Amies PL, Gelder MG, Shaw PM (1983) Social phobia: A comparative clinical study. Br J Psychiatry 142:174–179

    Google Scholar 

  • Angst J, Dobler-Mikola A (1984) The Zurich study. II. The continuum for normal to pathological depressive mood swings. Eur Arch Psychiatry Neurol Sci 234:21–29

    Google Scholar 

  • Angst J, Dobler-Mikola A (1985) The Zurich Study. V. Anxiety and phobia in young adults. Eur Arch Psychiatry Neurol Sci 235:171–178

    Google Scholar 

  • Angst J, Dobler-Mikola A, Binder J (1984) The Zurich Study — A prospective epidemiological study of depressive neurotic and psychosomatic syndrome. I. Problem, Methodology. Eur Arch Psychiatry Neurol Sci 234:13–20

    Google Scholar 

  • Beidel DC (1989) Test Anxiety and social phobia. A report to the social phobia subworkgroup for DSM-IV

  • Beidel DC, Turner SM (1988) Psychophysiological assessment of anxious emotional states in children. J Abnorm Psychol 97:80–82

    Google Scholar 

  • Benedikt N (1870) Über “Platzschwindel”. Allg Wien Med Z 15:488–489

    Google Scholar 

  • Bibb J, Chambless DL (1986) Alcohol use and abuse among diagnosed agoraphobics. Behav Res Ther 24:49–58

    Google Scholar 

  • Bowen RC, Fischer DG, Barrett P, D'Arcy C (1987) The relationship between agoraphobia, social phobia and blood-injury phobia in phobic and anxious-depressed patients. Can J Psychiatry 32:275–281

    Google Scholar 

  • Cameron OG, Thyer BA, Nesse RM, Curtis GC (1986) Symptom profiles of patients with DSM-III anxiety disorders. Am J Psychiatry 143:1132–1137

    Google Scholar 

  • Canino GJ, Bird HR, Shrout PE, Rubio-Stiper M, Bravo M, Martinez R, Sesman M, Guevara LM (1987) The prevalence of specific psychiatric disorders in Puerto Rico. Arch Gen Psychiatry 44:727–735

    Google Scholar 

  • Derogatis LR (1977) SCL-90. Administration, scoring and procedures Manual-I for the R (revised) version and other instruments of the Psychopathology Rating Scale Series. Johns Hopkins University School of Medicine, Chicago

    Google Scholar 

  • Dixon JJ, Monchaux C de, Sandler J (1957) Patterns of anxiety: An analysis of social anxieties. Br J Med Psychol 30:107–112

    Google Scholar 

  • Eaton WW, Dryman A, Weissman MM (1991) In: Robins LN, Regier DA (eds) Psychiatric disorders in America. The epidemiologic Catchment area study. The Free Press, New York, pp 155–179

    Google Scholar 

  • Fahrenberg J, Selg H, Hampel R (1978) Das Freiburger Persönlichkeitsinventar FPI, 3. Aufl. Verlag für Psychologie, Hogrefe CJ, Böttingen

    Google Scholar 

  • Faravelli C, Guerrini Degl'Innocenti B, Giardinelli L (1989) Epidemiology of anxiety disorders in Florence. Acta Psychiatr Scand 79:308–312

    Google Scholar 

  • Hallam RS, Hafner RJ (1978) Fears of phobic patients: Factor analyses of self-report data. Behav Res Ther 16:1–6

    Google Scholar 

  • Heimberg RG, Holt CS (1989) The issue of subtypes in the diagnosis of social phobia. A report to the social phobia subworkgroup for DSM-IV

  • Heimberg RG, Hope DA, Dodge CS, Becker RE (1990). DSM-III-R subtypes of social phobia: Comparison of generalized social phobics and public speaking phobics. J Nerv Ment Dis 178:172–179

    Google Scholar 

  • Joyce PR, Bushnell JA, Oakley-Browne MA, Welss JE, Hornblow AR (1989) The epidemiology of panic symptomatology and agoraphobic avoidance. Compr Psychiatry 30:303–312

    Google Scholar 

  • Kushner MG, Sher KG, Beitman BD (1990) The relation between alcohol problems and the anxiety disorders. Am J Psychaitry 147:685–695

    Google Scholar 

  • Liebowitz MR (1987) Social phobia. Mod Probl Pharmacopsychiatry 22:141–173

    Google Scholar 

  • Marks IM, Gelder MGA (1966) Different onset ages in varieties of phobia. Am J Psychiatry 123:218–221

    Google Scholar 

  • Marks IM (1970) The classification of phobic disorders. Br J Psychiatry 116:377–386

    Google Scholar 

  • Merikangas KR, Angst J (in press) Comorbidity of alcoholism and psychiatric disorders. Psychopharmacol Bull

  • Munjack DJ, Moss HB (1981) Affective disorder and alcoholism in families of agoraphobics. Arch Gen Psychiatry 38:869–871

    Google Scholar 

  • Noyes R, Crowe RR, Harris EL, Hamra BJ, McChesney CM, Chaudhry DR (1986) Relationship between panic disorder and agoraphobia: A family study. Arch Gen Psychiatry 43:227–232

    Google Scholar 

  • Öst LG (1990) The agoraphobia scale: An evaluation of its reliability and validity. Behav Res Ther 28:323–329

    Google Scholar 

  • Schneier FR, Martin LY, Liebowitz MR, Gorman JM, Fyer AJ (1989) Alcohol abuse in social phobia. J Anx Dis 3:15–23

    Google Scholar 

  • Solyom L, Ledwidge B, Solyom C (1986) Delineating social phobia. Br J Psychiatry 149:464–470

    Google Scholar 

  • Spielberger CD, Pollans C, Worden RJ (1984) Anxiety disorders. In: Hersen M, Turner SM (eds) Handbook of adult psychopathology. Wiley, New York

    Google Scholar 

  • Thompson AH, Bland RC, Orn HT (1989) Relationship and chronology of depression, agoraphobia, and panic disorder in the general population. J Nerv Ment Dis 177:456–463

    Google Scholar 

  • Thyer BA, Parrish RT, Himle J, Cameron OG, Curtis GC, Nesse RM (1986) Alcohol abuse among clinically anxious patients. Beh Res Ther 24:357–359

    Google Scholar 

  • Turner SM, Stanley MA, Beidel DC, Bond L (1989) The social phobia and anxiety inventory: Construct validity. J Psychopathol Behav Assess 11:221–234

    Google Scholar 

  • Wacker HR, Müllejans R, Klein KH, Battegay R (1992) Identification of cases of anxiety disorders and affective disorders in the community according to the ICD-10 and DSM-III-R using the composite international diagnostic interview (CIDI). Int J Methods Psychiatr Res 2:91–100

    Google Scholar 

  • Weissman MM, Merikangas KR (1986) The epidemiology of anxiety and panic disorders: An update. J Clin Psychiatry 47 [Suppl 6]:11–17

    Google Scholar 

  • Wells JE, Bushnell JA, Hornblow AR, Joyce PR, Oakley-Browne MA (1989) Christchurch psychiatric epidemiology study, part I. Methodology and lifetime prevalence for specific psychiatric disorders. Aust NZ J Psychiatry 23:315–326

    Google Scholar 

  • Westphal C (1872) Die Agoraphobie, eine neuropathische Erscheinung. Arch Psychiat Nervenkr 3:138–161

    Google Scholar 

  • Wittchen HV, Ahmoi Essau C, Zerssen D von, Krieg JC, Zandig M (1992) Lifetime and 6-month prevalence of mental disorders in the Munich follow-up study. Eur Arch-Psychiatry Clin Neurosci 241:247–258

    Google Scholar 

  • Yeh EK, Chang LY, Hwu HG, Yeh YL (1985) Lifetime prevalence of mental disorders in a Chinese metropolis and 2 townships. In: Proceedings International Symposium on Psychiatric Epidemiology, Taipei City. April 26–28, pp 175–197

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Degonda, M., Angst, J. The Zurich study. Eur Arch Psychiatry Clin Nuerosci 243, 95–102 (1993). https://doi.org/10.1007/BF02191571

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