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NEW YORK, Mar 16 (Reuters Health) - Although shyness and anxiety in social situations is normal for many teenagers, for a small portion of young people it is not just a phase they'll grow out of, according to a report.
In fact, young people whose symptoms are severe enough to be classified as social anxiety disorder (SAD) appear to be at increased risk for the later development of major depression, researchers suggest.
"We found that the presence of SAD in adolescence or early adulthood is a strong risk factor for the subsequent occurrence of depressive illness during young adulthood," according to a group of German and American researchers led by Dr. Murray B. Stein of the University of California, San Diego.
"Moreover...our observations suggest that those persons with the combination of SAD and depression in adolescence or early adulthood are at the greatest risk for subsequent depression (compared to those with just one of the two disorders)," the authors write.
The researchers interviewed more than 3,000 people between the ages of 14 and 24, all from Munich, Germany. At the beginning of the study, about 7% of participants had experienced social anxiety disorder at some point in their lives, and about 14% depressive disorder. About 2.5% had both conditions at the same time.
Stein and colleagues found that compared to peers with no emotional disorders, young people with either SAD or depression at the beginning of the study were about three times as likely to develop depressive disorder over the follow-up period, which lasted over 4 years.
But the biggest predictor of later depression was the combination of SAD and depression. Compared with young people with no emotional disorders, those with both SAD and depression were more than eight times more likely to have depressive disorder during follow-up.
Youngsters with both SAD and depression at the beginning of the study were also at risk for more severe depression, the authors note in the March issue of the Archives of General Psychiatry.
During the study, those with both conditions were more likely to contemplate or attempt suicide, had more symptoms of depression, and a longer duration of major episodes of depression than other young adults.
Although it is not clear that social anxiety disorder is the cause of depression, many factors link the two conditions, the report indicates. Social anxiety during adolescence can affect self-esteem and social isolation, both of which have been linked to the development of depression.
Regardless of the relationship, Stein and colleagues conclude that the findings support the idea that intervening early with youngsters who show signs of social anxiety disorder may help prevent the development of major depression--especially among those who show some signs of depression as well.
SOURCE: Archives of General Psychiatry 2001;58:251-256.
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