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dc.contributor.authorde Vries, Ymkje Annaen_US
dc.contributor.authorAl-Hamzawi, Alien_US
dc.contributor.authorAlonso, Jordien_US
dc.contributor.authorBorges, Guilhermeen_US
dc.contributor.authorBruffaerts, Ronnyen_US
dc.contributor.authorBunting, Brendanen_US
dc.contributor.authorCaldas-de-Almeida, José Miguelen_US
dc.contributor.authorCia, Alfredo Hen_US
dc.contributor.authorDe Girolamo, Giovannien_US
dc.contributor.authorDinolova, Rumyana Ven_US
dc.contributor.authorEsan, Oluyomien_US
dc.contributor.authorFlorescu, Silviaen_US
dc.contributor.authorGureje, Oyeen_US
dc.contributor.authorHaro, Josep Mariaen_US
dc.contributor.authorHu, Chiyien_US
dc.contributor.authorKaram, Elieen_US
dc.contributor.authorKaram, Aimeeen_US
dc.contributor.authorKawakami, Noritoen_US
dc.contributor.authorKiejna, Andrzejen_US
dc.contributor.authorKovess-Masfety, Vivianeen_US
dc.contributor.authorLee, Singen_US
dc.contributor.authorMneimneh, Zeinaen_US
dc.contributor.authorNavarro-Mateu, Fernandoen_US
dc.contributor.authorPiazza, Marinaen_US
dc.contributor.authorScott, Kateen_US
dc.contributor.authorTen Have, Margreeten_US
dc.contributor.authorTorres, Yolandaen_US
dc.contributor.authorViana, Maria Carmenen_US
dc.contributor.authorKessler, Ronald Cen_US
dc.contributor.authorde Jonge, Peteren_US
dc.description.abstractBackground: Specific phobia (SP) is a relatively common disorder associated with high levels of psychiatric comorbidity. Because of its early onset, SP may be a useful early marker of internalizing psychopathology, especially if generalized to multiple situations. This study aimed to evaluate the association of childhood generalized SP with comorbid internalizing disorders. Methods: We conducted retrospective analyses of the cross-sectional population-based World Mental Health Surveys using the Composite International Diagnostic Interview. Outcomes were lifetime prevalence, age of onset, and persistence of internalizing disorders; past-month disability; lifetime suicidality; and 12-month serious mental illness. Logistic and linear regressions were used to assess the association of these outcomes with the number of subtypes of childhood-onset (< 13 years) SP. Results: Among 123,628 respondents from 25 countries, retrospectively reported prevalence of childhood SP was 5.9%, 56% of whom reported one, 25% two, 10% three, and 8% four or more subtypes. Lifetime prevalence of internalizing disorders increased from 18.2% among those without childhood SP to 46.3% among those with one and 75.6% those with 4+ subtypes (OR = 2.4, 95% CI 2.3-2.5, p < 0.001). Twelve-month persistence of lifetime internalizing comorbidity at interview increased from 47.9% among those without childhood SP to 59.0% and 79.1% among those with 1 and 4+ subtypes (OR = 1.4, 95% CI 1.4-1.5, p < 0.001). Respondents with 4+ subtypes also reported significantly more disability (3.5 days out of role in the past month) than those without childhood SP (1.1 days) or with only 1 subtype (1.8 days) (B = 0.56, SE 0.06, p < 0.001) and a much higher rate of lifetime suicide attempts (16.8%) than those without childhood SP (2.0%) or with only 1 subtype (6.5%) (OR = 1.7, 95% CI 1.7-1.8, p < 0.001). Conclusions: This large international study shows that childhood-onset generalized SP is related to adverse outcomes in the internalizing domain throughout the life course. Comorbidity, persistence, and severity of internalizing disorders all increased with the number of childhood SP subtypes. Although our study cannot establish whether SP is causally associated with these poor outcomes or whether other factors, such as a shared underlying vulnerability, explain the association, our findings clearly show that childhood generalized SP identifies an important target group for early intervention.en_US
dc.subjectEarly markersen_US
dc.subjectInternalizing disordersen_US
dc.subjectSpecific phobiaen_US
dc.titleChildhood generalized specific phobia as an early marker of internalizing psychopathology across the lifespan: results from the World Mental Health Surveysen_US
dc.typeJournal Articleen_US
dc.contributor.affiliationFaculty of Medicineen_US
dc.relation.ispartoftextBMC Medicineen_US
dc.description.campusSGH campusen_US
Appears in Collections:Faculty of Medicine
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