Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland.
J Affect Disord. 2011 Sep;133(1-2):97-104. doi: 10.1016/j.jad.2011.03.036. Epub 2011 Apr 16.
Earlier studies suggest that social phobia (SP) and depression (DEP) often have their onset in adolescence, and are highly comorbid, with SP mainly preceding depression. There is a lack of population-based prospective studies among adolescents vulnerable to both disorders, taking into account possible gender differences in the relationship between the two.
This study is part of a prospective Adolescent Mental Health Cohort (AMHC) study. Subjects are 9th grade pupils (mean age 15.5 years (sd 0.39)) responding to a survey conducted 2002-2003 (T1) and a 2-year follow-up 2004-2005 (T2) (N=2038). Social phobia was measured by the Social Phobia Inventory (SPIN) and depression by the 13-item Beck Depression Inventory (BDI-13).
Risk for depression at T2 by SP at T1 was elevated only among boys (OR 3.6, 95% C.I. 1.507-8.579, p=0.004), whereas among girls, risk for SP at T2 by DEP at T1 was elevated (OR 7.8, 95% CI 4.529-13.391, p<0.001). The course of both disorders was unstable and recovery was common.
Lack of diagnostic interviews and fairly high drop-out rate (36.9%) in follow-up.
The relationship between SP and depression in adolescence seems different for boys and girls. Further studies are needed to explore factors explaining the different course of these disorders among boys and girls. Clinicians need to be alert to comorbidity when examining an adolescent with SP or depression.
早期研究表明，社交恐惧症（SP）和抑郁症（DEP）通常在青少年时期发病，且高度共病，以 SP 为主，随后是抑郁。在易患这两种疾病的青少年中，缺乏基于人群的前瞻性研究，同时考虑到这两种疾病之间关系的可能存在性别差异。
本研究是一项前瞻性青少年心理健康队列（AMHC）研究的一部分。研究对象为 9 年级学生（平均年龄 15.5 岁（标准差 0.39）），他们在 2002-2003 年（T1）进行了一项调查，并在 2004-2005 年（T2）进行了为期 2 年的随访（N=2038）。社交恐惧症采用社交恐惧症量表（SPIN）测量，抑郁采用贝克抑郁量表（BDI-13）测量。
T1 时的 SP 导致 T2 时患抑郁的风险仅在男孩中升高（OR 3.6，95%CI 1.507-8.579，p=0.004），而在女孩中，T1 时的 DEP 导致 T2 时患 SP 的风险升高（OR 7.8，95%CI 4.529-13.391，p<0.001）。两种疾病的病程均不稳定，康复较为常见。
缺乏诊断访谈和随访中相当高的脱落率（36.9%）。
青少年时期 SP 和抑郁之间的关系似乎因性别而异。需要进一步研究来探讨解释这些疾病在男孩和女孩中不同病程的因素。当检查患有 SP 或抑郁的青少年时，临床医生需要警惕共病。
