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Lifetime co-morbidities between social phobia and mood disorders in the US National Comorbidity Survey

Published online by Cambridge University Press:  01 May 1999

R. C. KESSLER ,
P. STANG ,
H.-U. WITTCHEN ,
M. STEIN  and
E. E. WALTERS
R. C. KESSLER
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, Department of Epidemiology, University of North Carolina, SmithKline-Beecham, NC and Department of Psychiatry, University of California, San Diego, CA, USA; and Department of Clinical Psychology, Max Planck Institute of Psychiatry, Munich, Germany
P. STANG
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, Department of Epidemiology, University of North Carolina, SmithKline-Beecham, NC and Department of Psychiatry, University of California, San Diego, CA, USA; and Department of Clinical Psychology, Max Planck Institute of Psychiatry, Munich, Germany
H.-U. WITTCHEN
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, Department of Epidemiology, University of North Carolina, SmithKline-Beecham, NC and Department of Psychiatry, University of California, San Diego, CA, USA; and Department of Clinical Psychology, Max Planck Institute of Psychiatry, Munich, Germany
M. STEIN
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, Department of Epidemiology, University of North Carolina, SmithKline-Beecham, NC and Department of Psychiatry, University of California, San Diego, CA, USA; and Department of Clinical Psychology, Max Planck Institute of Psychiatry, Munich, Germany
E. E. WALTERS
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, Department of Epidemiology, University of North Carolina, SmithKline-Beecham, NC and Department of Psychiatry, University of California, San Diego, CA, USA; and Department of Clinical Psychology, Max Planck Institute of Psychiatry, Munich, Germany
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Abstract

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Background. General population data were used to study co-morbidities between lifetime social phobia and mood disorders.

Methods. Data come from the US National Comorbidity Survey (NCS).

Results. Strong associations exist between lifetime social phobia and major depressive disorder (odds ratio 2·9), dysthymia (2·7) and bipolar disorder (5·9). Odds ratios increase in magnitude with number of social fears. Reported age of onset is earlier for social phobia than mood disorders in the vast majority of co-morbid cases. Temporally-primary social phobia predicts subsequent onset of mood disorders, with population attributable risk proportions of 10–15%. Social phobia is also associated with severity and persistence of co-morbid mood disorders.

Conclusions. Social phobia is a commonly occurring, chronic and seriously impairing disorder that is seldom treated unless it occurs in conjunction with another co-morbid condition. The adverse consequences of social phobia include increased risk of onset, severity and course of subsequent mood disorders. Early outreach and treatment of primary social phobia might not only reduce the prevalence of this disorder itself, but also the subsequent onset of mood disorders.

Type
Research Article
Information
Psychological Medicine , Volume 29 , Issue 3 , May 1999 , pp. 555 - 567
Copyright
© 1999 Cambridge University Press