title: Separation anxiety disorder from the perspective of DSM-5: clinical investigation among subjects with panic disorder and associations with mood disorders spectrum.
abstract: OBJECTIVE
  High levels of comorbidity between separation anxiety disorder (SEPAD) and panic disorder (PD) have been found in clinical settings. In addition, there is some evidence for a relationship involving bipolar disorder (BD) and combined PD and SEPAD. We aim to investigate the prevalence and correlates of SEPAD among patients with PD and whether the presence of SEPAD is associated with frank diagnoses of mood disorders or with mood spectrum symptoms.
  
  
  METHODS
  Adult outpatients (235) with PD were assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Panic Disorder Severity Scale (PDSS), the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS), and the Mood Spectrum Self-Report Instrument (MOODS-SR, lifetime version).
  
  
  RESULTS
  Of ther 235 subjects, 125 (53.2%) were categorized as having SEPAD and 110 (46.8%) as not. Groups did not differ regarding onset of PD, lifetime prevalence of obsessive compulsive disorder (OCD), social phobia, simple phobia, BD I and II, or major depressive disorder (MDD). SEPAD subjects were more likely to be female and younger; they showed higher rates of childhood SEPAD, higher PDSS scores, and higher MOODS-SR total and manic component scores than subjects without SEPAD. Discussion SEPAD is highly prevalent among PD subjects. Patients with both PD and SEPAD show higher lifetime mood spectrum symptoms than patients with PD alone. Specifically, SEPAD is correlated with the manic/hypomanic spectrum component.
  
  
  CONCLUSIONS
  Our data confirm the high prevalence of SEPAD in clinical settings. Moreover, our findings corroborate a relationship between mood disorders and SEPAD, highlighting a relationship between lifetime mood spectrum symptoms and SEPAD.
authors.affiliation: 1Department of Clinical and Experimental Medicine,Psychiatry Sector,University of Pisa,Pisa,Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Gesi
authors.affiliation: 1Department of Clinical and Experimental Medicine,Psychiatry Sector,University of Pisa,Pisa,Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Abelli
authors.affiliation: 1Department of Clinical and Experimental Medicine,Psychiatry Sector,University of Pisa,Pisa,Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Cardini
authors.affiliation: 1Department of Clinical and Experimental Medicine,Psychiatry Sector,University of Pisa,Pisa,Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Lari
authors.affiliation: 1Department of Clinical and Experimental Medicine,Psychiatry Sector,University of Pisa,Pisa,Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Di Paolo
authors.affiliation: 2Psychiatry Research and Teaching Unit,School of Psychiatry,University of New South Wales,Sydney,New South Wales,Australia.
authors.forename: Derrick
authors.initials: D
authors.lastname: Silove
authors.affiliation: 1Department of Clinical and Experimental Medicine,Psychiatry Sector,University of Pisa,Pisa,Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Pini
mesh_terms: D000328:Adult; D001010:Anxiety, Separation / Q000453:epidemiology*; D001714:Bipolar Disorder / Q000453:epidemiology*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology; D016584:Panic Disorder / Q000453:epidemiology*; D010698:Phobic Disorders / Q000453:epidemiology; D015995:Prevalence
keywords: Comorbidity; mood disorders; mood spectrum; panic disorder; separation anxiety