The cross-national epidemiology of specific phobia in the World Mental Health Surveys.

BACKGROUND: Although specific phobia is highly prevalent, associated with impairment, and an important risk factor for the development of other mental disorders, cross-national epidemiological data are scarce, especially from low- and middle-income countries. This paper presents epidemiological data from 22 low-, lower-middle-, upper-middle- and high-income countries. METHOD: Data came from 25 representative population-based surveys conducted in 22 countries (2001-2011) as part of the World Health Organization World Mental Health Surveys initiative (n = 124 902). The presence of specific phobia as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition was evaluated using the World Health Organization Composite International Diagnostic Interview. RESULTS: The cross-national lifetime and 12-month prevalence rates of specific phobia were, respectively, 7.4% and 5.5%, being higher in females (9.8 and 7.7%) than in males (4.9% and 3.3%) and higher in high- and higher-middle-income countries than in low-/lower-middle-income countries. The median age of onset was young (8 years). Of the 12-month patients, 18.7% reported severe role impairment (13.3-21.9% across income groups) and 23.1% reported any treatment (9.6-30.1% across income groups). Lifetime co-morbidity was observed in 60.5% of those with lifetime specific phobia, with the onset of specific phobia preceding the other disorder in most cases (72.6%). Interestingly, rates of impairment, treatment use and co-morbidity increased with the number of fear subtypes. CONCLUSIONS: Specific phobia is common and associated with impairment in a considerable percentage of cases. Importantly, specific phobia often precedes the onset of other mental disorders, making it a possible early-life indicator of psychopathology vulnerability.

[Family care for Moluccan ans Dutch elderly persons: a comparative study of readiness and expectations]. / Familiezorg voor Molukse en Nederlandse ouderen: een vergelijkend onderzoek naar bereidheid en verwachtingen.

Care expectations of Moluccan and Dutch elderly (n = 48), and the willingness of their children (n = 25) to provide care are explored. It appeared, that Moluccan elderly received more family care than the Dutch comparison group. Moluccan children were considered to be responsible for the care of the elderly as well as for arranging additional care. Dutch elder persons stressed that they didn't want to become a 'burden' to their children, and were more willing to call in professional help. However, all elderly persons were reluctant concerning the involvement of professional care. Dutch elder persons stressed their loss of independency. For Moluccan elderly, professional care did not fit in with their traditional (care) beliefs. In general, Moluccan children were more willing to provide care than Dutch children. However, many of them expected problems in combining family life, a job and the care of their parents. In this respect opinions of Moluccan and Dutch children were more alike than those of their parents.

[Activity level, boredom, health and participative climate in nursing homes]. / Activiteiten, verveling, gezondheid en het ervaren participatief klimaat in verzorgingshuizen.

In this paper an analysis is presented of factors accounting for differences in levels of boredom and activities of residents of homes for the aged. Eighty respondents in two homes for the aged were interviewed. Results indicate that residents with a positive perception of the participatory climate report lower levels of boredom but do not participate in activities more often than other residents. Moreover, persons who report psychological distress report higher levels of boredom. Other factors such as age, gender and level of activity do not seem to be related to boredom. It also appears that actual participation in activities is only predicted by age and two health indicators: health perception and ADL/HDL score. Persons who are younger and persons who report a better health situation participate more often in activities.