Associations of specific phobia and its subtypes with physical diseases: an adult community study.

Cornelia Witthauer,Peter Vollenweider,Martin Preisig,Roselind Lieb,Vladeta Ajdacic-Gross,Gerard Waeber,Andrea Hans Meyer

doi:10.1186/s12888-016-0863-0

Cornelia Witthauer, Peter Vollenweider + Show 5 more

Open Access

https://doi.org/10.1186/s12888-016-0863-0

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Abstract

BackgroundSpecific phobia is the most prevalent anxiety disorder in the community and is associated with substantial impairment. Comorbidity with physical diseases is assumed and has important implications for etiology, treatment, or prevention of the comorbid conditions. However, due to methodological issues data are limited and subtypes of specific phobia have not been investigated yet. We examined the association of specific phobia and its subtypes with physical diseases in a representative community sample with physician-diagnosed physical diseases and diagnostic criteria of specific phobia.MethodsData of the German Mental Health Survey from 4181 subjects aged 18–65 years were used. Specific phobia was diagnosed using M-CIDI/DIA-X interview; physical diseases were assessed through a self-report questionnaire and a medical interview. Logistic regression analyses adjusted for sex were calculated.ResultsSpecific phobia was associated with cardiac diseases, gastrointestinal diseases, respiratory diseases, arthritic conditions, migraine, and thyroid diseases (odds ratios between 1.49 and 2.53). Among the subtypes, different patterns of associations with physical diseases were established. The findings were partially replicated in the Swiss PsyCoLaus Study.ConclusionsOur analyses show that subjects with specific phobia have an increased probability for specific physical diseases. From these analyses etiological mechanisms of specific phobia and physical disease can be deduced. As subtypes differed in their patterns of associations with physical diseases, different etiological mechanisms may play a role. The findings are highly relevant for public health in terms of prevention and therapy of the comorbid conditions.

Highlights

Specific phobia is the most prevalent anxiety disorder in the community and is associated with substantial impairment
A study investigating the neural response during the presentation of phobia-specific stimuli established that subjects with animal phobia showed activation in dorsal anterior cingulate and anterior insula, in comparison to subjects with Blood Injection Phobia showing activation in the thalamus and visual/attention areas [35]. Based on these empirical findings, we suggest that specific phobia subtypes are associated with different physical diseases that may be linked to distinct physiological processes
As there is not enough empirical knowledge to formulate specific hypotheses concerning the associations between subtypes of specific phobia and physical diseases, we further investigated these associations in an explorative manner

Summary

Introduction

Specific phobia is the most prevalent anxiety disorder in the community and is associated with substantial impairment. Specific phobia is the most prevalent anxiety disorder in the community [1, 2]. It is associated with significant impairment and distress [3] and with a loss of work days [4]. Research has suggested that besides being comorbid with other mental disorders, specific phobia may be highly comorbid with physical diseases, too. A longitudinal analysis showed that self-reported gastrointestinal disease predicted the onset of specific phobia in older adults during the three years [15].

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