Comorbid Mental Disorders and Quality of Life in Patients with Social Phobia

Abstract

Introduction: the heterogeneity of psychopathological manifestations and the high comorbidity of social phobia with other mental disorders require the use the indicators of quality of life in the clinical assessment. Objective: determination of differences in quality of life indicators in patients with social phobia, comorbid with other mental disorders. Patients: 135 patients (78 women, 57 men) were examined with a diagnosis of social phobia (F40.1 according to ICD-10), comorbid with other mental disorders. Methods : clinical, psychopathological, psychometric (Liebowitz social anxiety scale — LSAS; Medical Outcomes Study — Short Form — MOS SF-36), statistical. Results: the structure of mental disorders comorbid with social phobia is presented by next diagnostic categories: F3 — affective disorders ( n = 27; 20.0%); F4 — neurotic, stress-related and somatoform disorders ( n = 90; 66.7%); F6 — personality disorders ( n = 18; 13.3%). Based on cluster analysis, patients were divided into three subgroups depending by severity of fear of social situations and social avoidance (low, medium or high level of social anxiety). It was found that an increasing in the level of social anxiety is associated with a rise in the proportion of comorbid disorders of the depressive spectrum, personality disorders and an greater share of generalized social phobia in clinical manifestations. Differences in the quality of life between subgroups were obtained on the four MOS SF-36 scales, reecting the physical component of health (role- physical functioning, p = 0.0023; general health, p = 0.0428) and the mental component of health (social functioning, p = 0.0076; mental health, p = 0.0106). However, only according to the scales of the mental component of health, an inverse relationship between quality of life indicators and the intensity of social anxiety was established. Conclusion: comorbid mental disorders and the level of social anxiety have a differentiated impact on the assessment of individual components of the quality of life by patients with social phobia. In this regard, it is necessary to analyze the inuence of personality, motivational and other individual psychological factors associated with distortions in the cognitive sphere.