Economic costs of social phobia: a population-based study.

BACKGROUND Information about the economic costs of social phobia is scant. In this study, we examine the economic costs of social phobia and subthreshold social phobia. METHODS Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) which is a population-based prospective study (n=4,789). Costs related to health service uptake, patients' out-of-pocket expenses, and costs arising from production losses were calculated for the reference year 2003. The costs for people with social phobia were compared with the costs for people with no mental disorder. RESULTS The annual per capita total costs of social phobia were euro 11,952 (95% CI=7,891-16,013) which is significantly higher than the total costs for people with no mental disorder, euro 2957 (95% CI=2690-3224). When adjusting for mental and somatic co-morbidity, the costs decreased to euro 6,100 (95% CI=2681-9519), or 136 million euro per year per 1 million inhabitants, which was still significantly higher than the costs for people with no mental disorder. The costs of subthreshold social phobia were also significantly higher than the costs for people without any mental disorder, at euro 4,687 (95% CI=2557-6816). LIMITATIONS The costs presented here are conservative lower estimates because we only included costs related to mental health services. CONCLUSIONS The economic costs associated with social phobia are substantial, and those of subthreshold social phobia approach those of the full-blown disorder.

[1]  Guidelines for pharmacoeconomic studies. , 1992, Clinical therapeutics.

[2]  A. Farmer,et al.  The Composite International Diagnostic Interview. An epidemiologic Instrument suitable for use in conjunction with different diagnostic systems and in different cultures. , 1988, Archives of general psychiatry.

[3]  F. Smit,et al.  Psychiatric and sociodemographic predictors of attrition in a longitudinal study: The Netherlands Mental Health Survey and Incidence Study (NEMESIS). , 2000, American journal of epidemiology.

[4]  C. Faravelli,et al.  A European perspective on social anxiety disorder , 2000, European Psychiatry.

[5]  H. Wittchen,et al.  The impact of social phobia on quality of life , 1996, International clinical psychopharmacology.

[6]  M. Weissman,et al.  Social Phobia: Comorbidity and Morbidity in an Epidemiologic Sample , 1992 .

[7]  Debbie Lim,et al.  Lost productivity among full-time workers with mental disorders. , 2000, The journal of mental health policy and economics.

[8]  L. Roijen,et al.  Manual Trimbos/iMTA Questionnaire for Costs Associated with Psychiatric Illness , 2002 .

[9]  M. Löthgren Economic evidence in anxiety disorders: a review , 2004, The European Journal of Health Economics.

[10]  M. First,et al.  The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description. , 1992, Archives of general psychiatry.

[11]  R. Kessler,et al.  The impact of psychiatric disorders on work loss days , 1997, Psychological Medicine.

[12]  T. B. Üstün,et al.  The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) , 2004, International journal of methods in psychiatric research.

[13]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[14]  M. Liebowitz,et al.  Functional impairment in social phobia. , 1994, The Journal of clinical psychiatry.

[15]  A. Leon,et al.  The Social Costs of Anxiety Disorders , 1995, British Journal of Psychiatry.

[16]  P. Cuijpers,et al.  Social phobia and number of social fears, and their association with comorbidity, health-related quality of life and help seeking , 2008, Social Psychiatry and Psychiatric Epidemiology.

[17]  R. Kessler,et al.  Social phobia subtypes in the National Comorbidity Survey. , 1998, The American journal of psychiatry.

[18]  R. Kessler,et al.  The economic burden of anxiety disorders in the 1990s. , 1999, The Journal of clinical psychiatry.

[19]  T. Furmark,et al.  Size and burden of social phobia in Europe , 2005, European Neuropsychopharmacology.

[20]  M. Liebowitz,et al.  Disability and quality of life in pure and comorbid social phobia. Findings from a controlled study , 1999, European Psychiatry.

[21]  R. Kessler,et al.  Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. , 1994, Archives of general psychiatry.

[22]  C. Blanco,et al.  The epidemiology of social anxiety disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. , 2005, The Journal of clinical psychiatry.

[23]  Dc Washington Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[24]  S. Kasper Social phobia: the nature of the disorder. , 1998, Journal of affective disorders.

[25]  W. Katon,et al.  Effectiveness research and implications for study design: sample size and statistical power. , 1999, General hospital psychiatry.

[26]  D. Baldwin,et al.  The economic consequences of social phobia. , 2002, Journal of affective disorders.

[27]  H. Wittchen,et al.  Cross-cultural Feasibility, Reliability and Sources of Variance of the Composite International Diagnostic Interview (CIDI) , 1991, British Journal of Psychiatry.

[28]  M. De Hert,et al.  Cost of disorders of the brain in Europe. , 2006, European journal of neurology.

[29]  M. Stein,et al.  Social phobia symptoms, subtypes, and severity: findings from a community survey. , 2000, Archives of general psychiatry.

[30]  A. Stiggelbout,et al.  Cost Measurement in Economic Evaluations of Health Care: Whom to Ask? , 2004, Medical care.

[31]  M. Stein,et al.  Social Phobia Symptoms, Subtypes, and Severity , 2000 .

[32]  A. Konnopka,et al.  Cost-of-illness studies and cost-effectiveness analyses in anxiety disorders: a systematic review. , 2009, Journal of affective disorders.

[33]  J A Reggia,et al.  A Neural Model of Memory Impairment in Di(cid:11)use Cerebral Atrophy , 2004 .

[34]  S. Montgomery Implications of the severity of social phobia. , 1998, Journal of affective disorders.

[35]  T. Furmark,et al.  Social phobia in the general population: prevalence and sociodemographic profile , 1999, Social Psychiatry and Psychiatric Epidemiology.

[36]  R. Bijl,et al.  The Netherlands Mental Health Survey and Incidence Study (NEMESIS): objectives and design , 1998, Social Psychiatry and Psychiatric Epidemiology.

[37]  R. Kessler,et al.  Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication , 2007, Psychological Medicine.

[38]  R. Bijl,et al.  Prevalence of psychiatric disorder in the general population: results of the Netherlands Mental Health Survey and Incidence Study (NEMESIS) , 1998, Social Psychiatry and Psychiatric Epidemiology.

[39]  R. Kessler,et al.  Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. , 1996, Archives of general psychiatry.

[40]  M. Koopmanschap,et al.  Productivity losses without absence: measurement validation and empirical evidence. , 1999, Health policy.

[41]  P. Cuijpers,et al.  Economic costs of minor depression: a population‐based study , 2007, Acta psychiatrica Scandinavica.

[42]  F. Smit,et al.  Economic costs of full-blown and subthreshold panic disorder. , 2007, Journal of affective disorders.

[43]  P. Cuijpers,et al.  Costs of nine common mental disorders: implications for curative and preventive psychiatry. , 2006, The journal of mental health policy and economics.