۱- Introduction

۲- Methods

۳- Results

۴- Discussion

References

Abstract

Objective: Immune-mediated inflammatory diseases (IMID) such as multiple sclerosis (MS), inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) are associated with a high prevalence of psychiatric comorbidity but little is known about the prevalence of social phobia in IMID, or the factors associated with social phobia. We aimed to determine the prevalence of social phobia in MS, IBD and RA, and the factors associated with social phobia in these IMID.
Methods: We obtained data from the enrollment visit of a cohort study in IMID of whom 654 participants were eligible for this analysis (MS: 254, IBD: 247, RA: 153). Each participant underwent a semi-structured psychiatric interview which identified depression and anxiety disorders including social phobia (lifetime and current), an assessment of disease activity, and reported sociodemographic information. Results: Overall, 12.8% of participants had a lifetime diagnosis of social phobia (MS: 10.2%, IBD: 13.0%, RA: 17.0%). Social phobia was associated with younger age (OR 0.98; 0.97-1.00), having a high school education or less (OR 1.78; 1.08-2.91), comorbid major depressive disorder (OR 2.79; 1.63-4.78) and comorbid generalized anxiety disorder (OR 2.56; 1.30-5.05). Persons with RA had increased odds of having social phobia as compared to persons with MS (OR 2.26; 1.14-4.48) but not IBD.
Conclusion: Persons with IMIDs have a relatively high lifetime prevalence of social phobia, exceeding that reported forthe Canadian general population. Strategies aimed at early detection, and effective clinical management of social phobia in IMID are warranted.

Introduction

Immune-mediated inflammatory diseases(IMID)such as multiple sclerosis (MS), inflammatory bowel disease (IBD) and rheumatoid arthritis (RA), are common in Canada. The inflammatory processes of these diseases affect different organ systems, yet all are associated with a higher prevalence of anxiety disordersthan in the general population.[1-3] In MS, for instance, comorbid anxiety disorders and other psychiatric disorders are associated with worsened fatigue, increased pain and lower adherence to disease-modifying medications.[4] Despite their adverse impacts, anxiety disorders typically remain underdiagnosed and undertreated in IMID,[5, 6] and are relatively understudied compare to depressive disorders. Anxiety disorders include panic disorders, generalized anxiety disorder (GAD), social anxiety disorder and specific phobias. Social anxiety disorder, also known as social phobia, is characterized by a fear of social situations in which the individual may be subjected to perceived scrutiny or criticism by others.[7] Social phobia is one of the most prevalent anxiety disorders with a lifetime prevalence of 8% in Canada.[8] The prevalence of social phobia is higher among women, and among individuals who are younger, with less education and lowersocioeconomic status, and limited social support.