Regular Article

Childhood Separation Anxiety and the Risk of Subsequent Psychopathology: Results from a Community Study
Tanja M. Brückl^a, Hans-Ulrich Wittchen^{a, b}, Michael Höfler^{a, b}, Hildegard Pfister^a, Silvia Schneider^c, Roselind Lieb<sup>a

a</sup>Department of Clinical Psychology and Epidemiology, Max Planck Institute of Psychiatry, Munich, and
^bDepartment of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany;
^cDepartment of Psychology, University of Basel, Basel, Switzerland

Address of Corresponding Author

Psychother Psychosom 2007;76:47-56 (DOI: 10.1159/000096364)

  Key Words

• Separation anxiety disorder
• Separation anxiety hypothesis
• Panic disorder
• Developmental psychopathology
• Childhood disorder

  Abstract

Objective: To examine the association between separation anxiety disorder (SAD) and mental disorders in a community sample and to evaluate whether separation anxiety is specifically related to panic disorder with and without agoraphobia. Method: The data come from a 4-year, prospective longitudinal study of a representative cohort of adolescents and young adults aged 14-24 years at baseline in Munich, Germany. The present analyses are based on a subsample of the younger cohort that completed baseline and two follow-up investigations (n = 1,090). DSM-IV diagnoses were made using the Munich Composite International Diagnostic Interview. Cox regressions with time-dependent covariates were used to examine whether prior SAD is associated with an increased risk for subsequent mental disorders. Results: Participants meeting DSM-IV criteria for SAD were at an increased risk of developing subsequent panic disorder with agoraphobia (PDAG) (HR = 18.1, 95% CI = 5.6-58.7), specific phobia (HR = 2.7, 95% CI = 1.001-7.6), generalized anxiety disorder (HR = 9.4, 95% CI = 1.8-48.7), obsessive-compulsive disorder (HR = 10.7, 95% CI = 1.7-66.1), bipolar disorder (HR = 7.7, 95% CI = 2.8-20.8), pain disorder (HR = 3.5, 95% CI = 1.3-9.1), and alcohol dependence (HR = 4.7, 95% CI = 1.7-12.4). Increased hazard rates for PDAG (HR = 4.2, 95% CI = 1.4-12.1), bipolar disorder type II (HR = 8.1, 95% CI = 2.3-27.4), pain disorder (HR = 1.9, 95% CI = 1.01-3.5), and alcohol dependence (HR = 2.1, 95% CI = 1.1-4.) were also found for subjects fulfilling subthreshold SAD. Conclusions: Although revealing a strong association between SAD and PDAG, our results argue against a specific SAD-PDAG relationship. PDAG was neither a specific outcome nor a complete mediator variable of SAD.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Dipl.-Psych. Tanja Brückl
Department of Clinical Psychology and Epidemiology
Max Planck Institute of Psychiatry, Kraepelinstrasse 2
DE-80804 München (Germany)
Tel. +49 89 3062 2613, Fax +49 89 3062 2544, E-Mail brueckl@mpipsykl.mpg.de

  Article Information

Number of Print Pages : 10
Number of Figures : 2, Number of Tables : 2, Number of References : 52