Comorbidity of generalized social anxiety disorder and depression in a pediatric primary care sample

J Affect Disord. 2004 Jun;80(2-3):163-71. doi: 10.1016/S0165-0327(03)00103-4.


Background: Comorbidity between adult social anxiety disorder and major depression is extensive. Considerably less information about this relationship is available among youth.

Methods: A randomly selected (from enrollees in a pediatric primary care clinic) sample of 190 families with children between the ages of 8 and 17 responded by mail to questionnaires assessing social anxiety, depression, and social functioning. Parents also completed a semi-structured telephone diagnostic interview about their child.

Results: The generalized type of social anxiety disorder was highly comorbid with major depression, generalized anxiety disorder, specific phobias, and ADHD, while little comorbidity was present for the nongeneralized subtype of social anxiety disorder. Logistic regression analyses indicated that generalized social anxiety disorder was the only anxiety disorder associated with an increased likelihood of major depression (OR=5.1). In all cases, social anxiety disorder had a significantly earlier age of onset than major depression.

Limitations: This study relies on cross-sectional data and diagnoses are based on parent reporting of child behavior.

Conclusions: Generalized social anxiety disorder is strongly associated with depressive illness in youth. Screening and treatment approaches that consider both social anxiety and depressive symptoms are necessary. Early intervention to treat social anxiety disorder may prevent later depressive disorders.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Comorbidity
  • Cross-Sectional Studies
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / epidemiology*
  • Female
  • Humans
  • Interview, Psychological
  • Male
  • Pediatrics*
  • Phobic Disorders / diagnosis
  • Phobic Disorders / epidemiology*
  • Primary Health Care*
  • Reproducibility of Results
  • Surveys and Questionnaires