Article

Childhood Separation Anxiety and the Risk of Subsequent Psychopathology: Results from a Community Study

Department of Clinical Psychology and Epidemiology, Max Planck Institute of Psychiatry, Munich, Germany.
Psychotherapy and Psychosomatics (Impact Factor: 9.2). 02/2007; 76(1):47-56. DOI: 10.1159/000096364
Source: PubMed

ABSTRACT

To examine the association between separation anxiety disorder (SAD) and mental disorders in a community sample and to evaluate whether separation anxiety is specifically related to panic disorder with and without agoraphobia.
The data come from a 4-year, prospective longitudinal study of a representative cohort of adolescents and young adults aged 14-24 years at baseline in Munich, Germany. The present analyses are based on a subsample of the younger cohort that completed baseline and two follow-up investigations (n = 1,090). DSM-IV diagnoses were made using the Munich Composite International Diagnostic Interview. Cox regressions with time-dependent covariates were used to examine whether prior SAD is associated with an increased risk for subsequent mental disorders.
Participants meeting DSM-IV criteria for SAD were at an increased risk of developing subsequent panic disorder with agoraphobia (PDAG) (HR = 18.1, 95% CI = 5.6-58.7), specific phobia (HR = 2.7, 95% CI = 1.001-7.6), generalized anxiety disorder (HR = 9.4, 95% CI = 1.8-48.7), obsessive-compulsive disorder (HR = 10.7, 95% CI = 1.7-66.1), bipolar disorder (HR = 7.7, 95% CI = 2.8-20.8), pain disorder (HR = 3.5, 95% CI = 1.3-9.1), and alcohol dependence (HR = 4.7, 95% CI = 1.7-12.4). Increased hazard rates for PDAG (HR = 4.2, 95% CI = 1.4-12.1), bipolar disorder type II (HR = 8.1, 95% CI = 2.3-27.4), pain disorder (HR = 1.9, 95% CI = 1.01-3.5), and alcohol dependence (HR = 2.1, 95% CI = 1.1-4.) were also found for subjects fulfilling subthreshold SAD.
Although revealing a strong association between SAD and PDAG, our results argue against a specific SAD-PDAG relationship. PDAG was neither a specific outcome nor a complete mediator variable of SAD.

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Available from: Silvia Schneider, Aug 15, 2014
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    • "However findings on the role of SAD in the development of other disorders in adulthood are mixed. In some studies, SAD was reported to increase the risk of other disorders (e.g., panic disorder, MDD) (Bittner et al., 2004; Brückl et al., 2007: Lewinsohn et al., 1998), whereas other studies failed to replicate this association (Aschenbrand et al., 2003; Hayward et al., 2000; Silove et al., 1996). Furthermore, SAD tends to have a short duration of about 3 years (Lewinsohn et al., 1998). "
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