Judith Conradt

Frequency and comorbidity of social phobia and social fears in adolescents

This report presents findings on the frequency, comorbidity and psychosocial impairment of social phobia and social fears among 1035 adolescents, aged 12-17 years. The adolescents were randomly selected from 36 schools in the province of Bremen, Germany. Social phobia and other psychiatric disorders were coded based on DSM-IV criteria using the computerized Munich version of the Composite International Diagnostic Interview. Seventeen (1.6%) of the adolescents met the DSM-IV criteria for social phobia sometimes in their life. More girls than boys received the diagnosis of social phobia and the frequency of the disorder increased with age. The lifetime frequency of social fears were much higher than that of social phobia. The most common types of feared social situations were fear of doing something in front of other people, followed by public speaking. Social phobia comorbid highly with depressive disorders, somatoform disorders and substance use disorders. Despite the high level of psychosocial impairment experienced by cases with social phobia and those with any social fears, only a small portion of them did receive professional help.

Frequency, comorbidity, and psychosocial impairment of anxiety disorders in German adolescents.

The frequency, comorbidity, and psychosocial impairment of anxiety disorders among German adolescents was estimated from a survey of 1,035 students aged 12-17 years. The adolescents were randomly selected from 36 schools in the province of Bremen, Germany. Anxiety disorders and other psychiatric disorders were coded based on criteria from the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, using the computerized Munich version of the Composite International Diagnostic Interview. Anxiety disorders occurred frequently in our sample of adolescents, with a rate of 18.6%. When considering the subtypes of anxiety disorders, phobia was the most common. Posttraumatic stress disorder and obsessive-compulsive disorder occurred less frequently with rates below 2%. Panic disorder and generalized anxiety disorder were the least common, with rates well below 1%. Anxiety disorders were significantly higher in girls than in boys, and that the rates increased with age. Comorbidity occurs quite frequently, both within the anxiety disorders and also with other psychiatric disorders. The most common pattern of comorbidity was that of anxiety and depressive disorders. Although a high number of anxiety cases were psychosocially impaired, at least during the worst episode of their disorders, only a few of them sought treatment for their problems. We conclude by discussing some research priorities in the area of anxiety disorders in children and adolescents.

Frequency, comorbidity, and psychosocial impairment of specific phobia in adolescents.

Investigated the frequency, comorbidity, and psychosocial impairment of specific phobia and specific fears among 1,035 adolescents 12 to 17 years old. The adolescents were recruited from 36 schools in the province of Bremen, Germany. Specific phobia and other psychiatric disorders were coded based on Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) criteria using the computerized Munich version of the Composite International Diagnostic Interview (Wittchen & Pfister, 1996). Thirty-six (3.5%) of the adolescents met DSM-IV criteria for specific phobia sometime in their life. Of all the subtypes of specific phobia, animal and natural environment phobia were the most common. More girls than boys received the diagnosis of specific phobia. One third of the adolescents with specific phobia also had depressive and somatoform disorders. Despite the high level of psychosocial impairment experienced by individuals with specific phobia both during the worst episode of their disorder and in the last 4 weeks, only a small portion of them sought professional help.

Prevention of anxiety symptoms in children: results from a universal school-based trial.

The present study evaluated the effectiveness of a universal school-based cognitive behavior prevention program (the FRIENDS program) for childhood anxiety. Participants were 638 children, ages 9 to 12 years, from 14 schools in North Rhine-Westphalia, Germany. All the children completed standardized measures of anxiety and depression, social and adaptive functioning, coping strategies, social skills, and perfectionism before and after the 10-week FRIENDS program and at two follow-up assessments (6 and 12 months) or wait period. Children who participated in the FRIENDS program exhibited significantly fewer anxiety and depressive symptoms, and lower perfectionism scores than children in the control group at 12-month follow-up. Younger children (9-10-year-olds) displayed treatment gains immediately after the intervention, whereas older children (11-12-year-olds) showed anxiety reduction only at 6- and 12-month follow-up. Perfectionism and avoidant coping acted as mediators of pre- to postintervention changes in anxiety scores. This study provides empirical evidence for the utility of the FRIENDS program in reducing anxiety and depressive symptoms among German children.

Frequency, Comorbidity, and Psychosocial Impairment of Depressive Disorders in Adolescents.

The frequency, comorbidity, and psychosocial impairment of depressive disorders among adolescents was estimated from a survey of 1,035 students aged 12 to 17 years. The adolescents were randomly selected from 36 schools in the province of Bremen, Germany. Depressive disorders and other psychiatric disorders were coded based on DSM-IV criteria using the computerized Munich version of the Composite International Diagnostic Interview. A high proportion of our adolescents met the lifetime criteria for depressive disorders according to DSM-IV criteria, with a rate of 17.9%. Depressive disorders were significantly higher in females than in males. The rates for all of the disorders increased with age, with the greatest increase occurring mostly between the ages of 14 and 15; such increase was more prominent in females than in males. Our results imply the importance of identifying depressive disorders in adolescence and the need for preventive and intervention strategies.

Häufigkeit der Posttraumatischen Belastungsstörung bei Jugendlichen: Ergebnisse der Bremer Jugendstudie

The frequency and comorbidity of posttraumatic stress disorders (PTSD) were assessed together with the resultant psychosocial impairment in 1035 adolescents between the ages of 12 and 17 years. Posttraumatic stress disorder and other psychiatric disorders were coded on the basis of the DSM-IV criteria using the computerized personal interview of the Munich version of the Composite International Diagnostic Interview (CIDI). A total of 17 (1.6%) adolescents met the DSM-IV criteria for PTSD at some point in their life. Slightly more girls than boys met the criteria for the disorder, whose frequency increased with age. The lifetime prevalence of traumatic events is much higher still: 233 (22.5%) adolescents reported one or more traumatic events in their life. The types of traumatic events experienced by the greatest number of adolescents were: physical attack, injury, and serious accident. Boys experienced significantly more traumatic events than did girls. The occurrence of a traumatic event was mostly associated with hypervigilance and recurrent and intrusive psychological distress upon exposure to cues which symbolized the event itself or resembled an aspect thereof. PTSD occurred in highly frequent comorbidity with depressive disorders, somatoform disorders, and substance abuse. Over 90% of those with posttraumatic stress disorder were severely impaired in their daily life and activities. Despite the high-grade psychosocial impairment, only a small number sought professional help.

Häufigkeit und Komorbidität Somatoformer Störungen bei Jugendlichen: Ergebnisse der Bremer Jugendstudie

Zusammenfassung. Anhand von Daten der Bremer Jugendstudie werden in diesem Artikel Ergebnisse hinsichtlich der Haufigkeit und Komorbiditat sowie psychosozialer Beeintrachtigung durch Somatoforme Storungen bei Jugendlichen dargestellt. 136 Jugendliche (13,1 %) erfullten die Kriterien fur eine Somatoforme Storung, wobei signifikant mehr Madchen als Jungen von diesen Storungen betroffen waren. Von den Subtypen Somatoformer Storungen trat als haufigste die Undifferenzierte Somatoforme Storung auf, gefolgt von der Schmerzstorung und der Konversionsstorung. Auf der Symptomebene wurden Kopfschmerzen, das Gefuhl eines Kloses im Hals und Schmerzen im Bauchbereich am haufigsten mitgeteilt. Fast die Halfte der Jugendlichen mit Somatoformen Storungen erfullte die Kriterien fur mindestens eine weitere Storung. Obwohl ein Drittel dieser Jugendlichen psychosozial beeintrachtigt war, wurde nur ein kleiner Teil von ihnen behandelt.

Frequency of panic attacks and panic disorder in adolescents.

By using data from the Bremer Adolescent Study, this report presents findings on the frequency, comorbidity, and psychosocial impairment of panic disorder and panic attacks among 1,035 adolescents. The adolescents were randomly selected from 36 schools in the province of Bremen, Germany. Panic disorder and other psychiatric disorders were coded based on DSM-IV criteria using the computerized-assisted personal interview of the Munich version of the Composite International Diagnostic Interview. Panic disorder occurred rather rare, with only 0.5% of all the adolescents met the DSM-IV criteria for this disorder sometimes in their live. Panic attack occurred more frequently, with 18% of the adolescents reported having had at least one panic attack. Slightly more girls than boys had panic attack and panic disorder. The occurrence of panic attack and panic disorder were the greatest among the 14–15 year olds. The experience of having a panic attack was associated with a number of problems, the most frequent being avoiding the situation for fear of having another attack. Four most common symptoms associated with a panic attack were that of palpitations, trembling/shaking, nausea or abdominal distress, and chills or hot flushes. Panic disorder comorbid highly with other psychiatric disorders covered in our study, especially with that of major depression. Among those with a panic disorder, about 40% of them were severely impaired during the worst episode of their illness. Only one out of five adolescents with panic disorder sought professional help for emotional and psychiatric problems. The implication of our findings for research and clinical practice are discussed. Depression and Anxiety 9:19–26, 1999.

Validität und Reliabilität der SCL-90-R: Ergebnisse der Bremer Jugendstudie

Zusammenfassung: Die Symptomcheckliste SCL-90-R (Derogatis, 1977; Franke, 1995) quantifiziert die aktuelle Belastung durch allgemeine klinisch-psychologische Symptome. Sie findet Anwendung in unterschiedlichen Bereichen von Wissenschaft und Praxis. Im englischen Sprachraum hat sich der Einsatz der SCL-90-R auch bei Jugendlichen bewahrt. Fur die deutschsprachige Version fehlen bisher Daten zur Reliabilitat und Validitat fur die Verwendung bei Jugendlichen. Im Rahmen dieser Arbeit werden verschiedene Gutekriterien und die Anwendbarkeit der SCL-90-R bei Jugendlichen anhand der Ergebnisse einer Subpopulation der Bremer Jugendstudie (N = 852) uberpruft. In Vergleichen mit den Diagnosen des standardisierten diagnostischen Interviews M-CIDI (Munchener Version des Composite International Diagnostic Interview) kann eine hohe generelle Ubereinstimmung zwischen erhohten Werten der Symptomcheckliste und verschiedenen Storungsdiagnosen nach den Kriterien des DSM-IV festgestellt werden. Es zeigt sich weiterhin ein Zusa...

Prevalence, comorbidity and psychosocial impairment of somatoform disorders in adolescents

The frequency, comorbidity and psychosocial impairment of somatoform disorders among adolescents was estimated from a survey of 1,035 students aged 12-17 years. The adolescents were randomly selected from 36 schools in the province of Bremen, Germany. Somatoform disorders and other psychiatric disorders were assessed using the computerized Munich version of the Composite International Diagnostic Interview (CIDI). About 13.1% of the adolescents met the DSM-IV criteria for any somatoform disorders, with significantly more girls than boys being affected by these disorders. Of the sub-types of somatoform disorders, the most common was that of undifferentiated somatoform disorders, followed by pain disorder, and conversion disorder. On the symptom level, the most common were headache, lump in throat, and abdominal pain. Almost half of those with somatoform disorders met the criteria for at least one other disorder covered in our study. Although most of these adolescents were psychosocially impaired, only a sma...