title: Clinical correlates and significance of separation anxiety in patients with bipolar disorder.
abstract: OBJECTIVE
  To evaluate frequency and severity of separation anxiety (SA) symptoms, as well as frequency of DSM-IV diagnosis of childhood separation anxiety disorder (CSAD) and adult separation anxiety disorder (ASAD), in a group of patients with bipolar disorder (BD) when compared with patients with panic disorder (PD) or major depression (MDD) and to a control group of healthy individuals (HC).
  
  
  METHODS
  Outpatients with, respectively, bipolar I disorder (BD), PD, MDD and a group of individuals with no psychiatric diagnoses (HC) were assessed for diagnosis by the SCID-I and for SA by the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS), the Separation Anxiety Symptoms Inventory (SASI) and the Adult Separation Anxiety Checklist (ASA-CL).
  
  
  RESULTS
  Thirty-one patients with BD without comorbid PD (BD-PD), 22 with BD with comorbid PD (BD + PD), 24 with PD, 20 with MDD and 15 HC were included in the analyses. As to childhood SA, the BD-PD group had higher scores than PD group and HC. The BD + PD group had higher scores than the PD group, MDD group and HC. As to adulthood SA, the BD-PD group had higher scores than HC on both SCI-SAS and Adult Separation Anxiety Questionnaire (ASA-27). The BD + PD had higher scores on both scales than BD-PD, PD group, MDD group and HC. The PD group and MDD group had higher scores than HC on the ASA-27. Adult SA symptoms were significantly associated with an earlier age at onset of BD.
  
  
  CONCLUSIONS
  This is the first study, to our knowledge, exploring the frequency and severity of SA symptoms during childhood and adulthood in a sample of bipolar patients in comparison to subjects with other anxiety and mood disorders. Our data appear to be preliminary grounds for investigating further the possibility that SA may deserve greater recognition in adults with BD.
authors: Department of Psychiatry, Neurobiology, Pharmacology and Biotechnologies, School of Medicine, University of Pisa, Pisa, Italy. s.pini@psico.med.unipi.it
authors: Stefano
authors: S
authors: Pini
authors: Marianna
authors: M
authors: Abelli
authors: Mauro
authors: M
authors: Mauri
authors: Matteo
authors: M
authors: Muti
authors: Paolo
authors: P
authors: Iazzetta
authors: Susanna
authors: S
authors: Banti
authors: Giovanni B
authors: GB
authors: Cassano
mesh_terms: D000328:Adult; D001010:Anxiety, Separation / Q000175:diagnosis / Q000523:psychology*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology*; D016009:Chi-Square Distribution; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D016584:Panic Disorder / Q000175:diagnosis / Q000523:psychology