Associations between adolescent social phobia, sickness absence and unemployment: a prospective study of twins in Sweden

Abstract

Background: Little is known about adolescent mental health problems, including social phobia, as risk factors for future work incapacity. The aim of this study was to investigate the association between social phobia in adolescence and unemployment and sickness absence (SA) in early adulthood, also evaluating the role of familial factors (genetics and shared environment).

Methods: A sample of 2845 Swedish twins born in 1985-86 in Sweden was followed longitudinally in the population-based and prospective Twin study of CHild and Adolescent Development. Information on twins' social phobia was collected at ages 13-4, 16-7 and 19-20 years. Logistic regression providing odds ratios (OR) with 95% confidence intervals (95% CI) was used to analyze the associations between social phobia, unemployment and SA during the follow-up 2006-12. The influence of familial factors was evaluated by conditional logistic regression.

Results: Presence of social phobia during adolescence was associated with increased odds for unemployment and SA in young adulthood. For unemployment, the highest OR was at the age of 13-4 years (1.58 [95% CI: 1.22-2.06]), and the associations became null after adjusting for familial factors. For SA, the highest OR was at the age of 19-20 years (1.73 [95% CI: 1.13-2.65]), and the estimates changed slightly after adjusting for familial factors.

Conclusions: : Results suggest that social phobia experienced in adolescence contribute to early adulthood unemployment and SA. Familial factors seemed to explain the association between social phobia and unemployment.