Social phobia in a population-based female adolescent twin sample: co-morbidity and associated suicide-related symptoms.
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 comorbid MDD predicts a substantially elevated risk of ALD and suicide-related symptoms, stressing the need for early SP detection.
Nelson
E C
EC
Missouri Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis 63108, USA.
Grant
J D
JD
Bucholz
K K
KK
Glowinski
A
A
Madden PAF
Reich
W
W
Heath
A C
AC
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000235:genetics; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000235:genetics; D005163:Factor Analysis, Statistical; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008923:Missouri / Q000453:epidemiology; D008957:Models, Genetic; D010698:Phobic Disorders / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D011159:Population Surveillance; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012306:Risk; D013405:Suicide / Q000523:psychology*