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Prevalence of common phobias and their socio-demographic …-10 most common phobias

ORIGINAL Afr J Psychiatry 2011;14:140-145
Prevalence of common phobias
and their socio-demographic
correlates in children and
adolescents in a traditional
developing society
A Bener1,2, S Ghuloum3, EE Dafeeah3
1Department of Medical Statistics & Epidemiology, Hamad General Hospital and Hamad Deptartment of Public Health, Medical
Corporation & Weill Cornell Medical College, Doha, Qatar
2Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester,
Manchester, United Kingdom
3Department of Psychiatry, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
Objective: The aim of this study was to identify the most common phobias in children and adolescents and to determine the
prevalence, age distribution, and socio-demographic correlates of phobias. Method: This was a prospective cross-sectional study
conducted at public and private schools from July 2009 to February 2009. The questionnaire included socio-demographic
information, extra-curricular activities and hobbies, behaviour at home and various phobic fears and it was distributed among
children aged 6 to 18 years. Psychiatrists determined the definitive diagnosis for various phobias by checking and screening
their symptoms. Results: Of the studied subjects, 44% were males and 56% were females. The overall prevalence of phobia in
children and adolescents was 19.7%. Among children with phobia, females had higher rates of phobias (62.4% vs 37.6%) than
males. Nearly half of total sufferers were in the 12-15 year age group (46.3%). Social phobia (12.7%) was the commonest phobia
found followed by agoraphobia (8.6%). Secondary school children were highly afflicted with social phobia (14.9%), agoraphobia
(11.7%) and specific phobia (9.6%), while preparatory students (8.3%) were more likely to have `medical' phobia (fear of physical
illness, medical tests and procedures). A significant difference was observed between the age groups in children with agoraphobia
(p=0.002). Conclusion: The overall prevalence of phobia in children and adolescents in Qatar was higher than rates found in other
epidemiologic studies, with the most common phobias observed being social phobia, agoraphobia and specific phobia.
Key Words: Prevalence; Phobia; Children; Qatar
Received: 15-03-2010
Accepted: 12-05-2010
doi: 10.4314/ajpsy.v14i2.6
Introduction response to a frightening event or situation. Large scale
Phobias are the most common anxiety disorders in epidemiological surveys suggest that 5 to 20% of all
childhood. A phobia is defined as an irrational and children and adolescents are afflicted with at least one
excessive fear of an object or situation.1 Phobias usually anxiety disorder.1-3 In one of the few studies of impairing
develop in late childhood, adolescence or early adult life in childhood anxiety disorders, the prevalence was greater
than 10%.4 Also, in a large U.S survey, the prevalence
ranged from 12% to 20%.2 The phobic disorders cause
Correspondence severe impairment and excessive distress. Although
Prof. A Bener effective psychosocial and drug therapies exist, these
PO Box 3050, Doha, State of Qatar anxious youngsters are virtually ignored compared with
Email: abener@hmc.org.qa and abb2007@qatar-med.cornell.edu children with other psychiatric problems. There has been a
African Journal of Psychiatry ? May 2011 140
ORIGINAL Afr J Psychiatry 2011;14:140-145
recent increase in interest regarding phobias because of second and third stages using the same simple random
higher-than-expected incidences; and phobia leads to sampling procedure, finally resulting in the selection of
disrupted relationship, severe anxiety and depression. 2200 students representing a true random sample of the
Social phobia includes fears involving other people or study population, which is 1.5% of total students in Qatar.
social situations such as performance anxiety or fears of Data collection took place from July to February 2010.
embarrassment by scrutiny of others. 6.8% of the American The questionnaires with a letter of explanation were
adult population (which is approximately 115 million) suffer distributed to the parents of the children studying at
from social phobia.5 Specific phobia is fear of a single primary levels and living in both urban and semi-urban
specific panic trigger such as spiders, dogs, elevators, areas of Qatar. Preparatory and secondary school students
water, flying, catching a specific illness, etc.6 An estimated had completed the questionnaires and returned them to
8.7% of Americans (or 19.2 million adults) suffer from a the nurse in-charge of the school. Content validity, face
specific phobia.7 Agoraphobia is characterized by intense validity and reliability of the questionnaire were tested
anxiety about being in a place or situation from which using 100 children. These tests demonstrated a high level
escape might be difficult or embarrassing in the event of a of validity and high degree of repeatability (kappa = 0.82).
panic attack. Agoraphobia is commonly associated with A total of 2250 students were approached and 1703
panic disorder. `Medical' phobia is the fear of physical students participated in the study with a response rate of
illness, medical tests and procedures. 75.7%. Non-responders were randomly distributed across
According to the Diagnostic and Statistical Manual of all schools. The study excluded students aged below 6
Mental Disorders6, 4th Edition (DSM-IV), social phobia, years and above 18 years and those who refused to give
specific phobia and agoraphobia are subgroups of anxiety consent to take part in the study.
disorders. Studies published in recent years confirm the The questionnaire had four parts: the first included the
high prevalence of specific phobias in the general socio-demographic details of the students; the second
population, especially in children.7-8 Children's fears differ included extra-curricular activities and hobbies; the third
in nature across different ethnic groups and culture, beliefs, part behaviour at home; and the fourth part was a
values and traditions may play a role in their expression. diagnostic screening questionnaire which consisted of 39
Researchers believe that a combination of genetic and fears related to phobias. Students were asked to answer the
environmental influences results in the emergence and questions by indicating `yes' or `No.' Only results from the
maintenance of social phobia. If left untreated, individuals 1st and 4th sections of the questionnaire are reported here.
with social phobia rarely recover. Child psychiatrists made psychiatric diagnoses. Two
Phobias in children may be particularly under- senior psychiatrists then independently reassessed these
recognized because their presentation may be regarded diagnoses through a systematic review of the symptoms.
as mere fears or may be misdiagnosed because of Psychiatric diagnoses generated from this reassessment
symptom overlap with other anxiety disorders and were jointly discussed and a consensus diagnosis was
depression.9 So far, no study has been conducted on the taken as final. IRB approval was obtained from the Hamad
prevalence of phobias among school children and Medical Corporation for conducting this research in Qatar.
adolescents in the State of Qatar. The aim of this study was Student`s t-tests were used to ascertain the significance
to investigate the most common phobias and determine of differences between mean values of two continuous
the prevalence of phobias in school children and variables and confirmed by non-parametric Mann-Whitney
adolescents and their socio-demographic correlates, in test. Chi-square analysis was performed to test for
particular gender. differences in proportions of categorical variables between
two or more groups. The level p

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