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Persistence of Specific Phobia From Adolescence to Early Adulthood: Longitudinal Follow-Up of the Mexican Adolescent Mental Health Survey

J Clin Psychiatry 2017;78(3):340–346
10.4088/JCP.15m10569

Background: Specific phobia is one of the most common psychiatric disorders in the general population, begins at a younger age, and has high comorbidity. However, it receives less treatment than other disorders, perhaps because it is circumscribed to a specific object or situation that can be avoided or is difficult to differentiate from developmentally adaptive fear. Longitudinal studies are needed to clarify its clinical significance, risk factors, and course. This study was designed to determine the persistence of specific phobia in participants during an 8-year period from adolescence to young adulthood and its predictors in a Mexican cohort.

Methods: 1,071 respondents from a representative 2-wave panel sample participated in the Mexican Adolescent Mental Health Survey in 2005 and in the follow-up survey in 2013. DSM-IV disorders were evaluated with the World Mental Health Composite International Diagnostic Interview.

Results: Of adolescents with specific phobia at baseline, 17.46% persisted into adulthood. Persistence of specific phobia was predicted by an age of onset of disorder in adolescence (risk ratio [RR] = 2.83, 95% CI, 1.30–6.13), parental neglect (RR = 2.76, 95% CI, 1.35–5.65), a first-degree relative with specific phobia (RR = 2.69, 95% CI, 1.34–5.39) and economic adversities (RR = 2.06, 95% CI, 1.21–3.53). Noncomorbid specific phobia in adolescence predicted incidence of other anxiety and substance use disorders in early adulthood (RR = 1.98; 95% CI, 1.11–3.54 and RR = 1.35; 95% CI, 1.07–1.69, respectively).

Conclusions: While many adolescents with specific phobia remit in adulthood, there are early adult consequences of adolescent phobia and identifiable risk factors for persistence that suggest a group of adolescents that might benefit from early intervention.