Pure animal phobia is more specific than other specific phobias: epidemiological evidence from the Zurich Study, the ZInEP and the PsyCoLaus

Subtypes of alcohol use disorder in the general population: A latent class analysis

Alcohol use disorders (AUD) are often comorbid with other disorders with high levels of impairment, which is of relevance for the development and the progression of the disease. Evidence shows that AUD varies greatly with regard to its aetiology, which might lead to distinct clinical representations with important implications for treatment. The current study aimed to apply latent class analysis (LCA) techniques to investigate how comorbidity patterns in AUD vary with regard to specific explanatory factors. A Swiss community sample of N=439 individuals with AUD was subjected to LCA in order to find empirical AUD subtypes of comorbid psychiatric conditions. The subtypes were further validated based on a range of external criteria, including clinical and psycho-social factors as well as treatment variables. A three-class solution of empirical subtypes of AUD comorbidity (low, depressive-anxious, and drug-dependent antisocial) provided the best fit to the data. The three AUD subtypes showed homogeneous comorbidity patterns but varied along dimensions of psycho-social risk factors, consumption patterns and consequences as well as treatment history. Our findings provide strong evidence that AUD in non-treated samples can be described as a multidimensional disorder in terms of its comorbidity structure with distinct etiological factors and important consequences for treatment.

Sex differences in neurodevelopmental and common mental disorders examined from three epidemiological perspectives

Sex differences in neurodevelopmental and common mental disorders are a ubiquitous, well-known, though poorly understood phenomenon. This study examined the issue from three epidemiological perspectives: congruence in age of onset, distribution of sex-ratios with respect to age of onset and similarity of comorbidity and risk factor patterns. The analysis was based on data from the population-based PsyCoLaus study (N = 4874, age 35-82 y). Congruence in age of onset and distribution of sex-ratios were examined with the Mann-Whitney test and cluster analysis. The similarity of comorbidity and risk factor patterns, which were represented by 35 variables, was assessed with the Jaccard coefficient and, after factor analysis, with Tucker's congruence coefficient. While age of onset parameters differed little by sex, the sex ratio varied markedly both in early and in late onset disorders. Moreover, the Jaccard coefficients for most disorders indicated that the similarity of comorbidity and further association patterns was low. Similarly, Tucker's congruence coefficient remained below the range of fair similarity in all factor combinations. In sum, sex differences in common mental disorders were impressively reflected by diverging sex ratios and comorbidity / risk factor patterns. This outcome supports the notion that most mental disorders need a sex-specific etiopathogenetic understanding.

Subtypes of stuttering determined by latent class analysis in two Swiss epidemiological surveys

Aims

Associations between stuttering in childhood and a broad spectrum of risk factors, associated factors and comorbidities were examined in two large epidemiological studies. Subtypes of stuttering were then identified based on latent class analysis (LCA).

Methods

Data were from two representative Swiss population samples: PsyCoLaus (N = 4,874, age 35–82 years) and the ZInEP Epidemiology Survey (N = 1,500, age 20–41 years). Associations between stuttering and sociodemographic characteristics, familial aggregation, comorbidity and psychosocial risk / associated factors were investigated in both samples. LCAs were conducted on selected items from people in both samples who reported having stuttered in childhood.

Results

Initial analyses linked early anxiety disorders, such as separation anxiety disorder and overanxious disorder, to stuttering (PsyCoLaus). ADHD was associated with stuttering in both datasets. In the analyses of risk / associated factors, dysfunctional parental relationships, inter-parental violence and further childhood adversities were mutual predictors of stuttering. Moreover, comorbidities were seen with hay fever, asthma, eczema and psoriasis (PsyCoLaus). Subsequent LCA identified an unspecific group of persons who self-reported that they stuttered and a group defined by associations with psychosocial adversities (ZINEP, PsyCoLaus) and atopic diseases (PsyCoLaus).

Conclusions

The two subtypes of developmental stuttering have different risk / associated factors and comorbidity patterns. Most of the factors are associated with vulnerability mechanisms that occur early in life and that have also been linked with other neurodevelopmental disorders. Both psychosocial and biological factors appear to be involved in the etiopathogenesis of stuttering.

Integrating Hypnosis with Other Therapies for Treating Specific Phobias: A Case Series

There is a high prevalence of anxiety disorders including specific phobias and panic disorder in the United States and Europe. A variety of therapeutic modalities including pharmacotherapy, cognitive behavioral therapy, systematic desensitization, hypnosis, in vivo exposure, and virtual reality exposure therapy have been applied. No one modality has been entirely successful. There has been only a limited attempt to combine psychological therapies in the treatment of specific phobias and panic disorder and what has been done has been primarily with systematic desensitization or cognitive behavioral therapy along with hypnotherapy. I present two cases of multiple specific phobias that were successfully treated with hypnotherapy combined with virtual reality exposure therapy or in vivo exposure therapy. The rationale for this integrative therapy and the neurobiological constructs are considered.

The spider and the snake - A psychometric study of two phobias and insights from the Hungarian validation

Specific phobias-particularly zoophobias-are prevalent worldwide and can have fairly dramatic health consequences. Self-report measurements play a crucial role in phobia research studies; thus, it is important to have a reliable tool in different languages. The present investigation examined the psychometric properties of the Hungarian version of two commonly used measures of fear: the Spider Phobia Questionnaire (i.e. SPQ) and the Snake Questionnaire (i.e. SNAQ). The SPQ and SNAQ scores both demonstrated excellent reliability, including a test-retest over a 4-week period. Supportive evidence for the validity of the SPQ and SNAQ scores was found using questions assessing fainting and avoidance history, regarding snakes and spiders, based on DSM-V criteria. Both questionnaires could discriminate between participants who reported such an event and those who did not. Further analyses also revealed a sex difference, with women scoring higher than men on both scales. Moreover, 9.5% and 4.24% of the respondents reached the cut-off point, set by previous studies, for spider and snake phobias, respectively. These findings suggest that the SPQ and SNAQ have excellent psychometric properties, making them suitable for use in further cross-cultural research and epidemiological studies.

Infectious, atopic and inflammatory diseases, childhood adversities and familial aggregation are independently associated with the risk for mental disorders: Results from a large Swiss epidemiological study

AIM

To examine the associations between mental disorders and infectious, atopic, inflammatory diseases while adjusting for other risk factors.

METHODS

We used data from PsyCoLaus, a large Swiss Population Cohort Study (n = 3720; age range 35-66). Lifetime diagnoses of mental disorders were grouped into the following categories: Neurodevelopmental, anxiety (early and late onset), mood and substance disorders. They were regressed on infectious, atopic and other inflammatory diseases adjusting for sex, educational level, familial aggregation, childhood adversities and traumatic experiences in childhood. A multivariate logistic regression was applied to each group of disorders. In a complementary analysis interactions with sex were introduced via nested effects.

RESULTS

Associations with infectious, atopic and other chronic inflammatory diseases were observable together with consistent effects of childhood adversities and familial aggregation, and less consistent effects of trauma in each group of mental disorders. Streptococcal infections were associated with neurodevelopmental disorders (men), and measles/mumps/rubella-infections with early and late anxiety disorders (women). Gastric inflammatory diseases took effect in mood disorders (both sexes) and in early disorders (men). Similarly, irritable bowel syndrome was prominent in a sex-specific way in mood disorders in women, and, moreover, was associated with early and late anxiety disorders. Atopic diseases were associated with late anxiety disorders. Acne (associations with mood disorders in men) and psoriasis (associations with early anxiety disorders in men and mood disorders in women) contributed sex-specific results. Urinary tract infections were associated with mood disorders and, in addition, in a sex-specific way with late anxiety disorders (men), and neurodevelopmental and early anxiety disorders (women).

CONCLUSION

Infectious, atopic and inflammatory diseases are important risk factors for all groups of mental disorders. The sexual dimorphism of the associations is pronounced.

Social Phobia Is Associated with Delayed Onset of Chickenpox, Measles, and Mumps Infections

OBJECTIVE

Evidence showing that infectious diseases in childhood play an important role in the etiopathogenesis of neurodevelopmental and other mental disorders is growing. The aim of this study was to explore the timing of common childhood diseases in early-onset anxiety disorders.

MATERIALS AND METHODS

We analyzed data from PsyCoLaus, a large Swiss Population Cohort Study (N = 3720). In this study, we regressed overanxious disorder, separation anxiety disorder, social phobia, and specific phobias on the age of onset of several childhood diseases, always adjusting for the other anxiety disorders listed above and for sex.

RESULTS

The timing of viral childhood diseases (chickenpox, measles, and mumps) was consistently delayed in social phobia, notably both in men and women. We found no evidence for a reversed sequence of onset of phobia symptoms before that of the infections included.

CONCLUSION

Social phobia was the only early anxiety disorder to show an association with a delayed onset of common viral childhood diseases.