(PS1-60) Psychopathological Differences in Symptoms of Social Anxiety Disorder Between Patients With or Without Comorbid Major Depressive Disorder in a Japanese Sample

Abstract Text: Social anxiety disorder (SAD) frequently co-occurs with major depressive disorder (MDD), and this comorbidity is associated with greater impairment than SAD alone. Furthermore, SAD patients with more severe MDD symptoms before undergoing cognitive-behavioral group therapy tended to experience less improvement in SAD symptoms following treatment. These findings suggest psychopathological differences exist in symptoms of SAD between patients with SAD and patients with SAD and comorbid MDD. This study examined the cross-sectional network structures of symptoms of SAD and explored differences between SAD patients with and without comorbid MDD. A total of 412 Japanese individuals with SAD (mean age = 42.33, SD = 10.14, 160 males, 252 females), participated in this study. The sample included 206 SAD patients with comorbid MDD and 206 SAD patients without comorbid MDD. Participants completed the Japanese version of the Liebowitz Social-Anxiety Scale (LSAS). A psychometric network analysis was conducted using the R package qgraph to examine network structures for SAD patients with comorbid MDD and SAD patients without comorbid MDD. These network structures were compared using the R package Network Comparison Test (NCT), which assessed overall structural consistency between groups and differences in global network connectivity. Results showed that SAD patients with comorbid MDD exhibited significantly higher symptoms of SAD than SAD patients without comorbid MDD (t = -4.16, p< .01). The central symptoms in the network of SAD patients without comorbid MDD were fear of talking with people you do not know well (LSAS-Fear item 11), fear of entering a room when others are already seated (LSAS-Fear item 14), avoidance of calling someone you do not know well (LSAS-Avoidance item 10), and avoidance of trying to pick up someone (LSAS-Avoidance item 21). In contrast, the central symptoms in the network of SAD patients with comorbid MDD were fear of entering a room when others are already seated (LSAS-Fear item 14), fear of trying to pick up someone (LSAS-Fear item 21), avoidance of talking to people authority (LSAS-Avoidance item 5), and avoidance of entering a room when others are already seated (LSAS-Avoidance item 14). The correlation stability coefficients were .36 for strength in both networks. The NCT indicated no significant differences between the networks of individuals with SAD and those with comorbid MDD in the global network structure (network invariance test: M = 0.22, p = .61) as well as connectivity (global strength invariance test: S = 0.49, p = .22; SSAD = 22.88, Scomorbid MDD = 23.38). However, the strength values for fear of urinating in a public bathroom (LSAS-Fear item 13) were significantly higher in the network of SAD patients without comorbid MDD than in the network of SAD patients with comorbid MDD. In conclusion, while SAD patients with comorbid MDD exhibited higher symptoms of SAD, their symptom networks did not significantly differ from SAD patients without comorbid MDD, suggesting similar psychopathology. Fear of entering a room with others seated may be a core symptom of SAD in both groups. We recommend that future research examines cross-cultural differences in these relationships.