The synergic relationship between social anxiety, depressive symptoms, poor sleep quality and body fatness in adolescents.

BACKGROUND: The aim of the current study was to evaluate the cross-sectional synergic relationship among social anxiety, poor sleep quality, depressive symptoms and body fatness. METHODS: A cross-sectional study was performed with 1,242 adolescents from a north-eastern district in Brazil. It was used the Social Anxiety Scale for Adolescents for symptoms of social anxiety, the Pittsburgh Sleep Quality Index for sleep quality and the Depression Scale of the Center for Epidemiologic Studies for depressive symptoms. Body fatness was the sum of triceps and subscapular skinfolds. Structural equation modelling was used to evaluate associations among these comorbidities. RESULTS: Social anxiety was directly and positively associated with depressive symptoms, poor sleep quality and body fatness (ß = 0.316 standard deviations [SD]; ß = 0.299 SD; ß = 0.072 SD, respectively). Moreover, social anxiety was indirectly associated with depressive symptoms via poor sleep quality (ß = 0.113 SD). Poor sleep quality was directly associated with depressive symptoms (ß = 0.377 SD). We did not observe a significant relationship of poor sleep quality and depressive symptoms with body fatness. LIMITATIONS: This is a cross-sectional study; therefore, we cannot infer causality in the interpretation of the findings. CONCLUSIONS: Social anxiety seemed to play pivotal role in adolescents' health, since it was associated with poor sleep quality, depressive symptoms and body fatness. Interventions targeting sleep quality, depressive symptoms and body fatness in adolescents should designate relevant effort addressing social anxiety.