Social phobia in a population-based female adolescent twin sample: co-morbidity and associated suicide-related symptoms

• Published in: Psychological medicine 2000-07, Vol.30 (4), p.797-804, Article S0033291799002275
• Main Authors: NELSON, E. C., GRANT, J. D., BUCHOLZ, K. K., GLOWINSKI, A., MADDEN, P. A. F., REICH, W., HEATH, A. C.
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent girls; Adult; Adult and adolescent clinical studies; Alcoholism - epidemiology; Alcoholism - genetics; Anxiety disorders. Neuroses; Biological and medical sciences; Comorbidity; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - genetics; Factor Analysis, Statistical; Female; Genetic Predisposition to Disease; Humans; Medical sciences; Missouri - epidemiology; Models, Genetic; Phobia; Phobic Disorders - epidemiology; Phobic Disorders - genetics; Phobic Disorders - psychology; Population Surveillance; Prevalence; Psychiatric disorders; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk; Social phobia; Suicidal behaviour; Suicide - psychology; Twins
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291799002275

Background. This report attempted to replicate and extend prior work examining social phobia (SP), co-morbid psychiatric illnesses, and the risk of suicidal ideation and suicide attempts incurred by their adolescent sufferers. Methods. SP, alcohol dependence (ALD) and major depressive disorder (MDD) diagnoses, and suicide-related symptoms, were assessed in a population-based adolescent female twin sample. The differentiation of risks as a function of co-morbidity was explored. A trivariate model was fitted to estimate sharing of genetic and environmental vulnerability between SP and co-morbid disorders. Results. The lifetime prevalence of SP was 16·3%. Significant risk for co-morbid MDD (OR = 3·2) and ALD (OR = 2·1) was observed. Strong evidence for shared genetic vulnerability between SP and MDD (respective heritabilities 28%, 45%; genetic r = 1·0) was observed with moderate support noted for similar sharing between SP and ALD (genetic r = 0·52, heritability for ALD 63%). SP with co-morbid MDD was associated with elevated risk for ALD and for suicide-related symptoms. Conclusions. SP is a common illness often followed by co-morbid MDD and ALD. SP with co-morbid MDD predicts a substantially elevated risk of ALD and suicide-related symptoms, stressing the need for early SP detection.