title: The relationship between adult separation anxiety disorder and complicated grief in a cohort of 454 outpatients with mood and anxiety disorders.
abstract: BACKGROUND
  Recent epidemiological studies indicate that separation anxiety disorder occurs more frequently in adults than children. Data from literature suggest that Adult Separation Anxiety Disorder (ASAD) may develop after a bereavement or threat of loss. Research has demonstrated that bereaved persons may present a clinically significant grief reaction, defined as Complicated Grief (CG) that causes a severe impairment in the quality of life. The aim of this study was to evaluate the relationship between ASAD and CG in a large cohort of outpatients with mood and anxiety disorders.
  
  
  METHODS
  Study participants comprised 454 adult psychiatric outpatients with DSM-IV mood or anxiety disorders diagnoses. Diagnostic assessments were performed using the SCID-I; ASAD was assessed using an adapted version of the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS-adult). Complicated grief symptoms were assessed by the Inventory of Complicated Grief (ICG). Social and work impairments were evaluated using the Sheehan Disability Scale (SDS). Adult attachment styles were assessed by the Relationship Questionnaire (RQ).
  
  
  RESULTS
  The overall frequency of ASAD in our sample was 43% and that of CG was 23%. Individuals with CG had a greater frequency of ASAD (56%) with respect to those without CG (40%). Subjects with CG plus ASAD reported higher scores on ICG and greater impairment on quality of life, as measured with SDS, than CG patients without ASAD.
  
  
  CONCLUSIONS
  Adult separation anxiety disorder occurs in a high proportion of adult psychiatric outpatients with complicated grief. The association between these two conditions should be further investigated in light of their clinical implications.
authors: Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, I-56100 Pisa, Italy. stefano.pini@med.unipi.it
authors: Stefano
authors: S
authors: Pini
authors: Camilla
authors: C
authors: Gesi
authors: Marianna
authors: M
authors: Abelli
authors: Matteo
authors: M
authors: Muti
authors: Lisa
authors: L
authors: Lari
authors: Alessandra
authors: A
authors: Cardini
authors: Vijaya
authors: V
authors: Manicavasagar
authors: Mauro
authors: M
authors: Mauri
authors: Giovanni B
authors: GB
authors: Cassano
authors: Katherine M
authors: KM
authors: Shear
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology*; D001010:Anxiety, Separation / Q000453:epidemiology / Q000523:psychology*; D001601:Bereavement; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006117:Grief; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000523:psychology*; D010045:Outpatients; D010555:Personality Inventory / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires