Social Phobia Among Depressed Individuals Entering Residential Rehabilitation Programmes: Prevalence and Correlates
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Social Phobia Among Depressed Individuals Entering Residential Rehabilitation Programmes: Prevalence and Correlates Katrina Prior 1
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& Joanne Ross & Katherine Mills & Maree Teesson
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# Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Social phobia commonly co-occurs with substance use disorders and depression; however, the prevalence and correlates of social phobia among individuals with both of these disorders remain unknown. Interviews were conducted with 120 individuals entering residential rehabilitation for substance use treatment, who endorsed criteria for major depression and were recruited to a randomised controlled trial. Nearly three quarters (72.5%) of the sample met diagnostic criteria for social phobia. These individuals were more likely to report problematic drinking, more severe anxiety and depressive rumination, and lower distress tolerance, compared to individuals without social phobia. When examining the impact of applying diagnostic exclusion rules for social phobia among this cohort, results indicate that one third (32.2%) of those with social phobia specified their fear was related to a co-occurring mental health and/or substance use disorder. This group—who would not have met diagnostic criteria for social phobia if exclusion rules were strictly followed—experienced more severe depression, anxiety, depressive rumination, and repetitive negative thinking than those who did not make such attributions. The high prevalence and burden associated with social phobia among depressed substance users highlight the importance of screening for, assessing, and treating the disorder upon entry to treatment, irrespective of whether symptoms are related to other conditions. Keywords Substance use . Substance dependence . Depression . Social phobia . Social anxiety . Residential rehabilitation
Highlights • Nearly three quarters of depressed substance users met diagnostic criteria for current social phobia. • A diagnosis of social phobia was associated with a more severe clinical profile. • Those who related their social phobia to comorbid substance use and/or mental disorders experienced greater impairment. • Important to assess for social phobia even if symptoms are perceived to be related to co-occurring conditions.
* Katrina Prior [email protected]
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The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Level 6, Jane Foss Russell Building (G02), Camperdown, NSW 2006, Australia
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National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
International Journal of Mental Health and Addiction
Mood disorders, particularly major depression, are common among individuals with substance use disorders (SUDs). National and international research has demonstrated that between 15 and 17% of people with a SUD in the general population experience comorbid depression in the same year (Grant et al. 2004; Mills et al. 2009). Among people in treatment for SUDs, this rate is even higher with between 2
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