Social anxiety disorder tied to later depression

Internal Medicine News, Feb 15, 2008 by Bruce Jancin

VIENNA -- Social anxiety disorder, regardless of age of onset, is consistently associated with strongly increased risk for later depression, according to 10-year results of the large prospective Early Developmental Stages of Psychopathology Study.

This conclusion is an about-face from an earlier report from the EDSP based on only 4 years of longitudinal follow-up. That report found that social anxiety disorder (SAD) was related to an increased risk of later depression only among individuals aged 18-24 years at SAD onset (Arch. Gen. Psychiatry 2001;58:251-6).

It is now quite clear that those with SAD onset before the age of 18 years had not yet been followed long enough to enter the prime period for onset of depression, Katja Beesdo, Ph.D., said at the annual congress of the European College of Neuropsychopharmacology.

EDSP enrolled 3,021 Munich youths at age 14-24 years and followed them prospectively for an average of 10 years. The cumulative incidence of SAD was 11% and of depression was 27%.

Adolescence is the most vulnerable period for the onset of SAD, according to Dr. Beesdo, a clinical psychologist at Technical University, Dresden, Germany.

Roughly 60% of the subjects with SAD were diagnosed with comorbid depression. In most cases, SAD was diagnosed first.

Participants with prior SAD were at twofold greater risk of developing depression than those without prior SAD. In a multivariate analysis, two significant factors differentiated the 60% of SAD patients who went on to meet criteria for depression from the 40% who did not: comorbid panic attacks and a more malignant course of SAD, as reflected in relatively high behavioral inhibition.

The German Federal Ministry of Education and Research funded the study.

BY BRUCE JANCIN

Denver Bureau