Social phobia prevalent in OCD patients

By Mark Cowen, Senior medwireNews Reporter

Social phobia is common among patients with obsessive compulsive disorder (OCD) and frequently co-occurs with other related disorders, researchers report.

Melissa Chagas Assunção (University Estadual Paulista, São Paulo, Brazil) and team found that more than a third of individuals with OCD had social phobia, which was significantly associated with male gender, lower socioeconomic status, body dysmorphic disorder, dysthymia, generalized anxiety disorder, and other mental health disorders.

"These findings have important implications for clinical practice, indicating the need for broader treatment approaches for individuals with this profile," they say in the Journal of Affective Disorders.

The team studied 1001 OCD patients (43.2% men), aged a mean of 34.8 years, from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders database, which includes comprehensive and standardized sociodemographic and clinical information.

All of the participants completed a variety of questionnaires, including the Beck depression and Beck anxiety inventories, the Yale-Brown obsessive-compulsive scale, the Dimensional Yale-Brown obsessive-compulsive scale, the OCD natural history questionnaire, and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis I disorders.

The researchers found that a total of 346 (34.6%) patients met DSM-IV criteria for social phobia, and these patients were more likely than those without to present with OCD symptoms of the "sexual/religious" and "hoarding" dimensions.

Logistic regression analyses revealed that the presence of social phobia in OCD patients was significantly associated with male gender (odds ratio [OR]=1.76) and being in the lower socioeconomic groups C, D and E (OR=1.55).

It was also significantly associated with the presence of other conditions, including body dysmorphic disorder (OR=2.96), specific phobia (OR=3.35), dysthymia (OR=1.98), generalized anxiety disorder (OR=2.10), agoraphobia (OR=2.09), Tourette syndrome (OR=1.98), and binge eating disorder (OR=1.74).

"Several of these additional disorders… present phenomenological features that are common to social phobia, such as an excessive preoccupation with the judgment of others, fear of being rejected or humiliated, feelings of inferiority, low self-esteem and low self-confidence, excessive self-demands and hypersensitivity to criticism," comment the researchers.

They conclude that the findings "may contribute to improving current understanding of this complex disorder and orient more comprehensive and effective therapeutic approaches."

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