{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T06:54:54Z","timestamp":1776322494459,"version":"3.50.1"},"reference-count":0,"publisher":"Juan Jos\u00e9 L\u00f3pez-Ibor Foundation","issue":"2","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Actas Esp Psiquiatr"],"abstract":"<jats:p>Objective: Social anxiety is a key risk factor for adolescent depression, yet its underlying mechanisms and subgroup differences remain unclear. This study explored the mediating roles of perceived social support and sleep quality in their link, and the moderating effects of visit type and gender.\nMethods: A retrospective observational study enrolled 386 depressed adolescents (12\u201318 years\u037e 231 outpatients, 155 inpatients) from Xiamen Xianyue Hospital. Social anxiety, depressive symptoms, perceived social support and sleep quality were assessed using the Social Anxiety Scale for Adolescents, Self-Rating Depression Scale, Multidimensional Scale of Perceived Social Support and Pittsburgh Sleep Quality Index, respectively. Pearson\u2019s correlation and Hayes\u2019 PROCESS macro (Model 6) were applied for mediation\/moderation analyses, with sensitivity testing via the Montgomery\u2013\u00c5sberg Depression Rating Scale (MADRS).\nResults: Inpatients and severe cases had higher Social Anxiety Scale for Adolescents (SAS-A), Zung Self-Rating Depression Scale (SDS) and Pittsburgh Sleep Quality Index (PSQI) and lower Multidimensional Scale of Perceived Social Support (MSPSS) scores (all p &lt; 0.001)\u037e females had higher social anxiety (p = 0.003). Social anxiety correlated positively with depressive symptoms (r = 0.54, p &lt; 0.001) and negatively with perceived social support (r = \u20130.49, p &lt; 0.001). Mediation analysis showed a total effect of social anxiety on depressive symptoms (\u03b2 = 0.304, p &lt; 0.001), with direct effect (57.5%, \u03b2 = 0.175) and total indirect effect (42.5%, \u03b2 = 0.130). Key indirect pathways: \u2018social anxiety \u2192 sleep quality \u2192 depressive symptoms\u2019 (27.0%) and a serial mediation pathway via perceived social support and sleep quality (8.2%)\u037e perceived social support\u2019s single mediation was marginally non-significant (p = 0.118). Moderation analyses revealed stronger direct effects in inpatients (\u03b2 = 0.342 vs. 0.097, p &lt; 0.001) and stronger sleep quality effects in females (\u03b2 = 1.125 vs. 0.619, p = 0.006). MADRS sensitivity analyses confirmed consistency (path coefficient deviations &lt;1%).\nConclusions: Social anxiety affects adolescent depressive symptoms directly and via sleep-related mediation, moderated by visit type and gender. Targeting social anxiety and sleep quality may optimise precision prevention\/treatment for adolescent depression.\u00a0<\/jats:p>","DOI":"10.62641\/aep.v54i2.2154","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T06:19:06Z","timestamp":1776320346000},"page":"348-361","source":"Crossref","is-referenced-by-count":0,"title":["Linking Social Anxiety to Depressive Symptoms in Adolescents: The Dual Mediating Roles of Perceived Social Support and Sleep Quality"],"prefix":"10.62641","volume":"54","author":[{"given":"Jing","family":"Gong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yajuan","family":"Ji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingsi","family":"Qu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaowei","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinchao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"48925","published-online":{"date-parts":[[2026,4,15]]},"container-title":["Actas Espa\u00f1olas de Psiquiatr\u00eda"],"original-title":[],"link":[{"URL":"https:\/\/actaspsiquiatria.es\/index.php\/actas\/article\/download\/2154\/2839","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaspsiquiatria.es\/index.php\/actas\/article\/download\/2154\/2839","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T06:19:06Z","timestamp":1776320346000},"score":1,"resource":{"primary":{"URL":"https:\/\/actaspsiquiatria.es\/index.php\/actas\/article\/view\/2154"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,15]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4,15]]}},"URL":"https:\/\/doi.org\/10.62641\/aep.v54i2.2154","relation":{},"ISSN":["1578-2735","1139-9287"],"issn-type":[{"value":"1578-2735","type":"electronic"},{"value":"1139-9287","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4,15]]}}}