Course and short-term outcomes of separation anxiety disorder in a community sample of twins.
OBJECTIVE
To assess the course and short-term outcomes associated with separation anxiety disorder (SAD) in a community setting.


METHODS
The subjects were 161 of 2,061 8- to 17-year-old twins with SAD from a community-based twin study. Subjects were born between 1974 and 1983. Subjects and parents were personally interviewed about the subject's current psychiatric history between 1990 and 1993. A follow-up interview was conducted, on average, 18 months later. Logistic regression was used to identify predictors and outcomes of persistent SAD.


RESULTS
Of the 161 subjects with SAD at time 1, 80% had remitted and 59% were free of any disorder at follow-up. Children with persistent SAD had a significantly higher prevalence of oppositional defiant disorder, significantly more impairment associated with symptoms of attention-deficit/hyperactivity disorder, and mothers who were less satisfied with their marriage at time 1 than children with transient episodes. Children with persistent SAD had a significantly higher prevalence of overanxious disorder or a new minor or major depressive disorder at time 2 than children with transient SAD. After controlling for comorbidity, only an elevated risk of new depressive disorders at time 2 distinguished children with persistent SAD.


CONCLUSIONS
Many children with SAD in a community setting are well at follow-up, on average, 18 months later. A minority of children with persistent SAD are at significantly increased risk of a new depressive disorder, especially those with a history of oppositional defiant disorder, impairment associated with symptoms of attention deficit hyperactivity disorder, or parental marital difficulties.
Human Genetics Department, Virginia Commonwealth University, Richmond 23298-0003, USA. dfoley@hsc.vcu.edu
Debra L
DL
Foley
Andrew
A
Pickles
Hermine M
HM
Maes
Judy L
JL
Silberg
Lindon J
LJ
Eaves
D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D001010:Anxiety, Separation / Q000175:diagnosis* / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D004200:Diseases in Twins / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D014768:Virginia