Psychological Medicine

Antecedents of the risk of recovery from DSM-III-R social phobia

D. J. DeWIT a1c1, A. OGBORNE a1, D. R. OFFORD a1 and K. MacDONALD a1
a1 Addiction Research Foundation Division, Centre for Addiction and Mental Health, London, Ontario; and Centre for Studies of Children at Risk, Hamilton Health Sciences Corporation and Faculty of Health Sciences, Chedoke-McMaster University, Hamilton, Ontario, Canada


Background. This study reports antecedents of recovery from DSM-III-R social phobia.

Methods. Retrospective data were obtained from 1116 individuals age 15 to 64 participating in a large population health survey in the province of Ontario, Canada.

Results. Approximately 50% of the sample recovered from their illness. Survival analysis revealed a median length of illness of 25 years with peak periods of risk of recovery occurring between 30 and 45 years duration. Using discrete time multivariate hazard regression analysis, statistically significant predictors of recovery from social phobia included: childhood social contextual factors (one or no childhood siblings, a small town childhood place of residence), characteristics of the disorder (onset past the age of 7, less than three disorder symptoms), an absence of co-morbid health-related conditions and psychiatric disorders (chronic health problems and major depression), and the occurrence of co-morbid chronic health problems and major depression prior to the onset of the disorder.

Conclusions. Our data indicate that social phobia in the general population is a chronic and unremittent disorder. Determinants of recovery are rooted in distal childhood circumstances, disorder attributes, and the physical and mental health status of individuals over the life course.

c1 Address for correspondence: Dr David J. DeWit, Addiction Research Foundation Division, Centre for Addiction and Mental Health, 100 Collip Circle, Suite 200, London, Ontario, Canada N6G 4X8.