Risk Factors and Comorbidity in Childhood Specific Phobias

This study aims to investigate possible risk factors associated with specific phobias in children and comorbid mental disorders. Patients between 6–18 years of age who had presented to the child psychiatry outpatient clinic at Bezmialem Vakif University between October 2017 and February 2018 were assessed with The Kiddie Schedule for Affective Disorders and Schizophrenia-Present version (KSADS-P) for specific phobias and comorbid diagnoses. Risk factors of specific phobia were further evaluated with a data collection tool, developed by the authors of the present study. The most common specific phobia subtype was animal phobia (n=48; 48%), which was followed by natural environment (n=27; 27%), blood-injection (n=25; 25%), situational (n=17; 17%) and other phobia (n=2; 2%). The majority of the subjects (n=59; 63.4%) reported that specific phobia began between 3–7 years of age. While% 32 percent of subjects reported a sudden onset, for 40% the onset was slow and gradual. Majority of the participants (67.7%) were not able to identify a possible trigger, whilst 25.3% reported that it started after a certain event. Only 10% of the participants had reportedly sought treatment for phobia in the past. Subjects with animal phobia or situational phobia had lower, blood/injection type phobia or natural environment type phobias had higher rates of comorbidity with an externalizing disorder as compared to the rest of the sample (Χ2=9.54, p=0.002 and Χ2=11.51, p=0.001, Χ2=6.00, p=0.014 and Χ2=8.45, p=0.004; respectively). In conclusion children and adolescents do not appear to seek help for specific phobias and such cases can be easily missed if not specifically enquired by clinicians.

Çocukluk çağı özgül Fobilerinde Risk Faktörleri ve Eştanılar

Bu araştırmada çocuklardaki özgül fobilerle ilişkili risk faktörlerinin ve eştanılarının incelenmesi amaçlanmıştır. Bezmialem Vakif Üniversitesi çocuk ruh sağlığı ayaktan tedavi ünitesine Ekim 2017 ve Şubat 2018 arasında başvuran 6–18 yaş hastalar özgül fobi ve eştanıları saptamak için, Okul Çağı Çocukları İçin Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi - güncel sürümü (ÇGDŞ-Ş) ile değerlendirildi. Özgül fobi ile ilişkili risk faktörleri çalışmanın yazarları tarafından geliştirilmiş bir veri toplama formu ile incelendi. En sık saptanan özgül fobi alt tipi hayvan fobisiydi (n=48; %48), onu doğal çevre fobisi (n=27; %27) kan-enjeksiyon fobisi (n=25; 25 %), durumsal fobi (n=17; 17 %) ve diğer fobiler (n=2; %2) takip etmekteydi. Olguların çoğu (n=59; %63,4), fobisinin 3–7 yaşları arasında başladığını bildirdi. Olguların %32’si ani başlangıç bildirirken %40’ı yavaş ve kademeli bir başlangıç bildirdi. Grubun büyük kısmı %67,7 %herhangi bir tetikleyici olay hatırlamazken, %25,3’ü fobinin belli bir olaydan sonra başladığını bildirdi. Olguların %10’u geçmişte fobisi için tedaviye başvurduğunu ifade etti. Grup eştanılar açısından incelendiğinde, hayvan fobisi veya durumsal fobisi olanlarda grubun kalanına göre daha az, kan/enjeksiyon tipi fobi veya doğal çevre tipi fobisi olanlarda ise daha fazla dışsallaştırıcı bozukluk eştanısı saptanmıştır (sırasıyla Χ2=9,54, p=0,002; Χ2=11,51, p=0,001; Χ2=6,00, p=0,014; Χ2=8,45, p=0,004). Sonuç olarak çocuk ve ergenlerin çoğunluğu özgül fobi için yardım arayışında değildir ve özellikle sorgulanmadığı takdirde kolaylıkla gözden kaçabilmektedir.

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