{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T20:20:57Z","timestamp":1783542057040,"version":"3.55.0"},"posted":{"date-parts":[[2026,7,6]]},"group-title":"Psychiatry and Clinical Psychology","reference-count":65,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,7,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>\n                  Social anxiety disorder (SAD) is among the most prevalent anxiety disorders, and it has been associated with signs of advanced biological ageing. Despite this, brain age research on anxiety disorders remains limited. This mega-analysis investigated brain ageing in adults with SAD within the ENIGMA-Anxiety Working Group. Structural MRI scans from 576 participants with SAD and 1 355 non-affected healthy controls (HCs) across 26 international samples were included. Brain age was estimated from 77 cortical and subcortical regions using a publicly available ENIGMA brain age model. The brain-predicted age difference (brain-PAD) was calculated as the difference between brain age and chronological age. Group and subgroup differences (comorbidity, medication) were assessed using linear mixed-effect models. In the full sample, there was no group difference in brain-PAD (\n                  <jats:bold>\u03b2<\/jats:bold>\n                  diagnosis (SE)=0.70 (0.37) years,\n                  <jats:italic>p<\/jats:italic>\n                  =0.061). In a subgroup of participants with SAD with comorbid anxiety disorders (n=184 SAD, n=1 355 HCs), a brain-PAD of +2.39 (0.93) years (Cohen\u2019s\n                  <jats:italic>d<\/jats:italic>\n                  =0.23,\n                  <jats:italic>p<\/jats:italic>\n                  FDR=0.003) was observed. This brain-PAD became smaller after exclusion of participants with comorbid agoraphobia and specific phobia, suggesting that these disorders may partly drive the advanced brain-PAD. In conclusion, this ENIGMA-Anxiety mega-analysis did not find evidence of advanced brain ageing in the full sample of adult participants with SAD relative to HCs. However, a sub-analysis suggested that SAD with co-occurring phobic disorders, or the phobic disorders themselves, are associated with neurostructural patterns typical of older brains. Future research could utilise transdiagnostic samples with information on age of onset and disorder duration to further clarify this relation.\n                <\/jats:p>","DOI":"10.64898\/2026.07.02.26357108","type":"posted-content","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T16:35:12Z","timestamp":1783355712000},"source":"Crossref","is-referenced-by-count":0,"title":["Brain Ageing in Social Anxiety Disorder: An ENIGMA-Anxiety Mega-Analysis Across 26 International Cohorts"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4376-5658","authenticated-orcid":false,"given":"Kimberly V.","family":"Blake","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Mental Health, Neuroscience Institute, University of Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1272-0032","authenticated-orcid":false,"given":"Jonathan C.","family":"Ipser","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Mental Health, Neuroscience Institute, University of Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5190-9597","authenticated-orcid":false,"given":"Alyssa R.","family":"Amod","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Mental Health, Neuroscience Institute, University of Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4003-1018","authenticated-orcid":false,"given":"Tobias","family":"Kaufmann","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University of T\u00fcbingen, T\u00fcbingen, Germany"},{"name":"German Center for Mental Health (DZPG), Partner Site T\u00fcbingen, T\u00fcbingen, Germany"},{"name":"Centre for Precision Psychiatry, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yair","family":"Bar-Haim","sequence":"additional","affiliation":[{"name":"Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9345-2126","authenticated-orcid":false,"given":"Jochen","family":"Bauer","sequence":"additional","affiliation":[{"name":"University Clinic for Radiology, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6588-3479","authenticated-orcid":false,"given":"Ali","family":"Bayram","sequence":"additional","affiliation":[{"name":"Istanbul University, Aziz Sancar Institute of Experimental Medicine, Department of Neuroscience, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9687-5527","authenticated-orcid":false,"given":"Katja","family":"Beesdo-Baum","sequence":"additional","affiliation":[{"name":"Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD - Dresden University of Technology, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Blanco-Hinojo","sequence":"additional","affiliation":[{"name":"MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2309-6079","authenticated-orcid":false,"given":"Tiana","family":"Borgers","sequence":"additional","affiliation":[{"name":"Institute for Translational Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"B\u00fclow","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Cano","sequence":"additional","affiliation":[{"name":"Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9633-0888","authenticated-orcid":false,"given":"Narc\u00eds","family":"Cardoner","sequence":"additional","affiliation":[{"name":"Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2921-3408","authenticated-orcid":false,"given":"Christopher R. 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