The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative

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dc.contributor.authorStein, Dan J
dc.contributor.authorLim, Carmen C W
dc.contributor.authorRoest, Annelieke M
dc.contributor.authorde Jonge, Peter
dc.contributor.authorAguilar-Gaxiola, Sergio
dc.contributor.authorAl-Hamzawi, Ali
dc.contributor.authorAlonso, Jordi
dc.contributor.authorBenjet, Corina
dc.contributor.authorBromet, Evelyn J
dc.contributor.authorBruffaerts, Ronny
dc.contributor.authorde Girolamo, Giovanni
dc.contributor.authorFlorescu, Silvia
dc.contributor.authorGureje, Oye
dc.contributor.authorHaro, Josep M
dc.contributor.authorHarris, Meredith G
dc.contributor.authorHe, Yanling
dc.contributor.authorHinkov, Hristo
dc.contributor.authorHoriguchi, Itsuko
dc.contributor.authorHu, Chiyi
dc.contributor.authorKaram, Aimee
dc.contributor.authorKaram, Elie G
dc.contributor.authorLee, Sing
dc.contributor.authorLepine, Jean-Pierre
dc.contributor.authorNavarro-Mateu, Fernando
dc.contributor.authorPennell, Beth-Ellen
dc.contributor.authorPiazza, Marina
dc.contributor.authorPosada-Villa, Jose
dc.contributor.authorten Have, Margreet
dc.contributor.authorTorres, Yolanda
dc.contributor.authorViana, Maria C
dc.contributor.authorWojtyniak, Bogdan
dc.contributor.authorXavier, Miguel
dc.contributor.authorKessler, Ronald C
dc.contributor.authorScott, Kate M
dc.date.accessioned2017-09-05T14:45:38Z
dc.date.available2017-09-05T14:45:38Z
dc.date.issued2017-07-31
dc.date.updated2017-08-06T03:32:55Z
dc.description.abstractBackground: There is evidence that social anxiety disorder (SAD) is a prevalent and disabling disorder. However, most of the available data on the epidemiology of this condition originate from high income countries in the West. The World Mental Health (WMH) Survey Initiative provides an opportunity to investigate the prevalence, course, impairment, socio-demographic correlates, comorbidity, and treatment of this condition across a range of high, middle, and low income countries in different geographic regions of the world, and to address the question of whether differences in SAD merely reflect differences in threshold for diagnosis. Methods: Data from 28 community surveys in the WMH Survey Initiative, with 142,405 respondents, were analyzed. We assessed the 30-day, 12-month, and lifetime prevalence of SAD, age of onset, and severity of role impairment associated with SAD, across countries. In addition, we investigated socio-demographic correlates of SAD, comorbidity of SAD with other mental disorders, and treatment of SAD in the combined sample. Cross-tabulations were used to calculate prevalence, impairment, comorbidity, and treatment. Survival analysis was used to estimate age of onset, and logistic regression and survival analyses were used to examine socio-demographic correlates. Results: SAD 30-day, 12-month, and lifetime prevalence estimates are 1.3, 2.4, and 4.0% across all countries. SAD prevalence rates are lowest in low/lower-middle income countries and in the African and Eastern Mediterranean regions, and highest in high income countries and in the Americas and the Western Pacific regions. Age of onset is early across the globe, and persistence is highest in upper-middle income countries, Africa, and the Eastern Mediterranean. There are some differences in domains of severe role impairment by country income level and geographic region, but there are no significant differences across different income level and geographic region in the proportion of respondents with any severe role impairment. Also, across countries SAD is associated with specific socio-demographic features (younger age, female gender, unmarried status, lower education, and lower income) and with similar patterns of comorbidity. Treatment rates for those with any impairment are lowest in low/lower-middle income countries and highest in high income countries. Conclusions: While differences in SAD prevalence across countries are apparent, we found a number of consistent patterns across the globe, including early age of onset, persistence, impairment in multiple domains, as well as characteristic sociodemographic correlates and associated psychiatric comorbidities. In addition, while there are some differences in the patterns of impairment associated with SAD across the globe, key similarities suggest that the threshold for diagnosis is similar regardless of country income levels or geographic location. Taken together, these cross-national data emphasize the international clinical and public health significance of SAD.
dc.identifier.apacitationStein, D. J., Lim, C. C. W., Roest, A. M., de Jonge, P., Aguilar-Gaxiola, S., Al-Hamzawi, A., ... Scott, K. M. (2017). The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative. <i>BMC Medicine</i>, http://hdl.handle.net/11427/25043en_ZA
dc.identifier.chicagocitationStein, Dan J, Carmen C W Lim, Annelieke M Roest, Peter de Jonge, Sergio Aguilar-Gaxiola, Ali Al-Hamzawi, Jordi Alonso, et al "The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative." <i>BMC Medicine</i> (2017) http://hdl.handle.net/11427/25043en_ZA
dc.identifier.citationStein, D. J., Lim, C. C., Roest, A. M., de Jonge, P., Aguilar-Gaxiola, S., Al-Hamzawi, A., ... & de Girolamo, G. (2017). The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative. BMC medicine, 15(1), 143.
dc.identifier.ris TY - Journal Article AU - Stein, Dan J AU - Lim, Carmen C W AU - Roest, Annelieke M AU - de Jonge, Peter AU - Aguilar-Gaxiola, Sergio AU - Al-Hamzawi, Ali AU - Alonso, Jordi AU - Benjet, Corina AU - Bromet, Evelyn J AU - Bruffaerts, Ronny AU - de Girolamo, Giovanni AU - Florescu, Silvia AU - Gureje, Oye AU - Haro, Josep M AU - Harris, Meredith G AU - He, Yanling AU - Hinkov, Hristo AU - Horiguchi, Itsuko AU - Hu, Chiyi AU - Karam, Aimee AU - Karam, Elie G AU - Lee, Sing AU - Lepine, Jean-Pierre AU - Navarro-Mateu, Fernando AU - Pennell, Beth-Ellen AU - Piazza, Marina AU - Posada-Villa, Jose AU - ten Have, Margreet AU - Torres, Yolanda AU - Viana, Maria C AU - Wojtyniak, Bogdan AU - Xavier, Miguel AU - Kessler, Ronald C AU - Scott, Kate M AB - Background: There is evidence that social anxiety disorder (SAD) is a prevalent and disabling disorder. However, most of the available data on the epidemiology of this condition originate from high income countries in the West. The World Mental Health (WMH) Survey Initiative provides an opportunity to investigate the prevalence, course, impairment, socio-demographic correlates, comorbidity, and treatment of this condition across a range of high, middle, and low income countries in different geographic regions of the world, and to address the question of whether differences in SAD merely reflect differences in threshold for diagnosis. Methods: Data from 28 community surveys in the WMH Survey Initiative, with 142,405 respondents, were analyzed. We assessed the 30-day, 12-month, and lifetime prevalence of SAD, age of onset, and severity of role impairment associated with SAD, across countries. In addition, we investigated socio-demographic correlates of SAD, comorbidity of SAD with other mental disorders, and treatment of SAD in the combined sample. Cross-tabulations were used to calculate prevalence, impairment, comorbidity, and treatment. Survival analysis was used to estimate age of onset, and logistic regression and survival analyses were used to examine socio-demographic correlates. Results: SAD 30-day, 12-month, and lifetime prevalence estimates are 1.3, 2.4, and 4.0% across all countries. SAD prevalence rates are lowest in low/lower-middle income countries and in the African and Eastern Mediterranean regions, and highest in high income countries and in the Americas and the Western Pacific regions. Age of onset is early across the globe, and persistence is highest in upper-middle income countries, Africa, and the Eastern Mediterranean. There are some differences in domains of severe role impairment by country income level and geographic region, but there are no significant differences across different income level and geographic region in the proportion of respondents with any severe role impairment. Also, across countries SAD is associated with specific socio-demographic features (younger age, female gender, unmarried status, lower education, and lower income) and with similar patterns of comorbidity. Treatment rates for those with any impairment are lowest in low/lower-middle income countries and highest in high income countries. Conclusions: While differences in SAD prevalence across countries are apparent, we found a number of consistent patterns across the globe, including early age of onset, persistence, impairment in multiple domains, as well as characteristic sociodemographic correlates and associated psychiatric comorbidities. In addition, while there are some differences in the patterns of impairment associated with SAD across the globe, key similarities suggest that the threshold for diagnosis is similar regardless of country income levels or geographic location. Taken together, these cross-national data emphasize the international clinical and public health significance of SAD. DA - 2017-07-31 DB - OpenUCT DO - 10.1186/s12916-017-0889-2 DP - University of Cape Town J1 - BMC Medicine LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative TI - The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative UR - http://hdl.handle.net/11427/25043 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/s12916-017-0889-2
dc.identifier.urihttp://hdl.handle.net/11427/25043
dc.identifier.vancouvercitationStein DJ, Lim CCW, Roest AM, de Jonge P, Aguilar-Gaxiola S, Al-Hamzawi A, et al. The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative. BMC Medicine. 2017; http://hdl.handle.net/11427/25043.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.publisher.departmentDepartment of Psychiatry and Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderThe Author(s).
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourceBMC Medicine
dc.source.urihttps://bmcmedicine.biomedcentral.com/
dc.subject.otherSocial anxiety disorder
dc.subject.otherSocial phobia
dc.subject.otherCross-national epidemiology
dc.subject.otherWorld Mental Health Survey Initiative
dc.titleThe cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative
dc.typeJournal Article
uct.type.filetypeText
uct.type.filetypeImage
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