Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Health Care Center, Hokkaido University, Sapporo, Japan.
PLoS One. 2021 Sep 27;16(9):e0257793. doi: 10.1371/journal.pone.0257793. eCollection 2021.
Social anxiety disorder (SAD) develops in the early teens and is a common disorder among university students. Understanding the predictive factors of SAD comorbid with major depressive episode (MDE) is important for student mental health care. The aim of this study was to identify the personality traits that predict SAD with MDE by analyzing longitudinal data of Japanese university students.
In this retrospective study, Japanese university students who visited the health care center of Hokkaido University for the first time were divided into the following four groups: "Control" (n = 43), "MDE" (n = 16), "SAD" (n = 28), and "SAD with MDE" (n = 61) based on the Patient Health Questionnaire-9 (PHQ-9), the Liebowitz Social Anxiety Scale, and core anxiety symptoms for SAD in the Mini International Neuropsychiatric Interview during screening. Predictors for SAD with MDE were identified by a four-group comparison of the Temperament and Character Inventory and PHQ-9 data previously obtained at the enrollment using analysis of variance and post-hoc tests.
Upon comparing the four groups using analysis of variance, there were significant differences in the baseline PHQ-9 summary score, Harm-Avoidance (HA), and Self-Directedness (SD). According to results of the post-hoc test, all three showed a significant difference between the "Control" and "SAD with MDE." Furthermore, there was a significant difference in HA scores between "SAD" and "Control." In all the groups, the mean time from enrollment to the first visit to the center was >2 years.
A higher HA score at baseline is a predictor of SAD with or without MDE. Higher PHQ-9 summary and lower SD scores at baseline are predictive factors of SAD with MDE.
社交焦虑障碍（SAD）在青少年早期发展，是大学生中常见的障碍。了解 SAD 合并重度抑郁发作（MDE）的预测因素对学生的心理健康护理很重要。本研究旨在通过分析日本大学生的纵向数据，确定预测 SAD 合并 MDE 的人格特质。
在这项回顾性研究中，根据患者健康问卷-9（PHQ-9）、Liebowitz 社交焦虑量表以及迷你国际神经精神访谈中的核心焦虑症状，首次到北海道大学保健中心就诊的日本大学生被分为以下四组：“对照组”（n=43）、“MDE 组”（n=16）、“SAD 组”（n=28）和“MDE 合并 SAD 组”（n=61）。使用方差分析和事后检验，对之前在入组时获得的气质与性格量表和 PHQ-9 数据进行四组比较，确定 MDE 合并 SAD 的预测因子。
方差分析比较四组时，基线 PHQ-9 总分、回避伤害（HA）和自我导向（SD）存在显著差异。事后检验结果显示，“对照组”和“MDE 合并 SAD 组”之间的所有三项均存在显著差异。此外，“SAD 组”和“对照组”之间的 HA 评分也存在显著差异。所有组中，从入组到首次就诊的平均时间均>2 年。
基线时 HA 评分较高是预测有无 MDE 合并 SAD 的指标。基线时 PHQ-9 总分较低和 SD 得分较低是预测 MDE 合并 SAD 的因素。
