Abstract
Background: Some studies have shown that anxiety is particularly frequent in the Clinical High Risk (CHR) for psychosis population. Notably, social anxiety disorder is identified as one of the most common anxiety disorders in CHR adolescents and young adults. Despite this, the frequency and the clinical significance of social anxiety in this population have been underestimated. Methods: A selective review of literature published between 2011 and 2017 on social anxiety disorder in CHR adolescents and young adults. Results: Five studies are included. In particular, three studies demonstrated that CHR adolescents and young adults have higher levels of anxiety compared to controls. Furthermore, anxiety, including social anxiety, is related to the severity of psychotic symptoms. The other studies included show inconsistent results regarding the possible relationship between social anxiety and social functioning. Conclusions: To date, the eidence concerning the comorbidity of social anxiety disorder and CHR in adolescents and young adults is not sufficient to provide clear guidelines for clinical practice. Future longitudinal studies on larger samples of the CHR adolescents and young adults are required to examine the relationship between social anxiety disorder and the presence of attenuated psychotic symptomatology.
Highlights
Recent years have seen an increase in clinical efforts towards intervention in the prodromal phase of the first psychotic episode
Serafini et al [1] shows that cannabis use/dependence may be critically engaged in determining negative outcomes such as suicidal behavior among psychotic youths and Clinical High Risk (CHR) patients with those who attempt or complete suicide who showed some additional risk factors for suicide such as mood disorders, stressful life events, interpersonal problems, poor social support, lonely lives, and hopelessness
The results showed that 58% of CHR met the criteria for clinical depression as measured by the Beck Depression Inventory [17] (BDI) (p = 0.034), and 42% met the criteria for social phobia based on the SIAS [15] (p = 0.004)
Summary
Recent years have seen an increase in clinical efforts towards intervention in the prodromal phase of the first psychotic episode. Criteria have been proposed to detect adolescents and young adults who are at Clinical High Risk (CHR) for psychosis. These criteria make a distinction between attenuated psychotic symptoms, brief intermittent psychotic symptoms, and genetic risk with a recent deterioration in functioning. Among the risk factors leading to a possible negative outcome for CHR adolescents and young adults, cannabis/use dependence and anxiety have an important role. Anxiety may be common in the CHR population: several studies [2,3,4,5] have shown that 24–53% of CHR patients have an anxiety disorder. Future longitudinal studies on larger samples of the CHR adolescents and young adults are required to examine the relationship between social anxiety disorder and the presence of attenuated psychotic symptomatology
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