title: Assessment of co-morbidity of adult separation anxiety in patients with bipolar disorder.
abstract: OBJECTIVE
  The aim of this study was to assess the co-morbidity of adult separation anxiety in bipolar patients and evaluate its effects on the course of disorder and functionality.
  
  
  METHODS
  A total of 70 patients who have been regularly followed in the Bipolar Disorder Unit were included in the study. The Structured Clinical Interview for DSM-IV - Axis I and Axis II disorders and demographic form were used. Separation anxiety was investigated by the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS) and the Hamilton Anxiety Rating Scale (HAM-A) was filled out by an interviewer. In addition, all patients completed the Bipolar Disorder Functioning Questionnaire (BDFQ), Separation Anxiety Symptom Inventory (SASI) and Adult Separation Anxiety Questionnaire (ASA).
  
  
  RESULTS
  The prevalence rate of co-morbid adult separation anxiety disorder (A-SepAD) was 54% (n = 38) in our sample. Age of onset was in adulthood among 36% of patients with a diagnosis of A-SepAD and the others (64%) were childhood-onset. Co-morbidity of personality disorders was more common in bipolar patients with childhood-onset separation anxiety disorder (C-SepAD). The lifetime prevalence of co-morbidity of specific phobias and number of suicide attempts were significantly higher in the group with A-SepAD. Functionality loss due to feeling of stigmatization was higher, and total functionality as measured by the BDFQ was found to be lower in bipolar patients with A-SepAD.
  
  
  CONCLUSIONS
  The results of this study have shown that 54% of bipolar patients had a diagnosis of A-SepAD. A-SepAD seems to increase the number of suicide attempts and have negative effects on functionality. A-SepAD should be assessed in regular interviews of patients with bipolar disorder.
authors.affiliation: a Ali Tasdemir, Cukurova University Faculty of Medicine Department of Psychiatry , Adana , Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Tasdemir
authors.affiliation: b Lut Tamam, Cukurova University Faculty of Medicine Department of Psychiatry , Adana , Turkey.
authors.forename: Lut
authors.initials: L
authors.lastname: Tamam
authors.affiliation: c Necla Keskin, Cukurova University Faculty of Medicine Department of Psychiatry , Adana , Turkey.
authors.forename: Necla
authors.initials: N
authors.lastname: Keskin
authors.affiliation: d YunusEmre Evlice, Cukurova University Faculty of Medicine Department of Psychiatry , Adana , Turkey.
authors.forename: Yunus Emre
authors.initials: YE
authors.lastname: Evlice
mesh_terms: D000328:Adult; D001010:Anxiety, Separation / Q000453:epidemiology*; D001714:Bipolar Disorder / Q000453:epidemiology*; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D015995:Prevalence; D013406:Suicide, Attempted; D011795:Surveys and Questionnaires
keywords: Bipolar disorder; Co-morbidity; Separation anxiety