Is adult-onset separation anxiety disorder a trauma-stress-related disorder? A preliminary report.

IF 4.1 3区医学 Q2 CLINICAL NEUROLOGY

CNS Spectrums Pub Date : 2025-07-21 DOI:10.1017/S1092852925000239

Camilla Gesi, Annalisa Cordone, Claudia Carmassi, Liliana Dell'Osso

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引用次数: 0

Abstract

Background: The DSM-5 recognized that the separation anxiety disorder (SEPAD) may span the entire life course or have an adult-onset. Epidemiological data indicated a 23%-69% prevalence of SEPAD in clinical settings and a high comorbidity with both prolonged grief disorder (PGD) and post-traumatic stress disorder (PTSD). Some authors hypothesize that while life threat represents the key trigger of PTSD, disruptions or threats to interpersonal bonds lead to PGD and SEPAD. This study aims to test the hypothesis that adult-onset SEPAD might be a trauma-related disorder, triggered by events threatening to interpersonal bonds.

Methods: The sample included 106 consecutive adult outpatients with anxiety and/or mood disorders. SEPAD was diagnosed according to DSM-5 criteria by means of the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS). The Adult Separation Anxiety Checklist (ASA-27) was used to assess symptoms severity. To assess exposure to trauma, the SCID-5 criterion A form for PTSD was administered. Traumatic events were coded as directly experienced (self) or involving close ones (others). Lifetime exposure to separation events was also assessed.

Results: 60.4% of participants were categorized as not having SEPAD in adulthood or in childhood (NO-SEPAD), 18.9% as childhood-onset SEPAD, and 20.8% as adult-onset SEPAD. Controlling for comorbid disorders, lifetime traumatic events involving self and separation events, traumatic events involving others significantly predicted adult-onset SEPAD. A significant correlation between the age at trauma exposure and the age of SEPAD onset was found.

Conclusions: Our results are consistent with the hypothesis that adult-onset SEPAD may represent an event-related disorder.

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成人发作的分离焦虑障碍是一种创伤应激相关障碍吗？初步报告。

背景：DSM-5承认分离焦虑障碍（SEPAD）可能跨越整个生命历程或有成人发病。流行病学数据显示，在临床环境中，SEPAD的患病率为23%-69%，并与长期悲伤障碍（PGD）和创伤后应激障碍（PTSD）有很高的合并症。一些作者假设，虽然生命威胁是PTSD的关键触发因素，但人际关系的中断或威胁会导致PGD和SEPAD。本研究旨在验证成人发病的SEPAD可能是一种创伤相关障碍的假设，由威胁人际关系的事件引发。方法：样本包括106例焦虑和/或情绪障碍的连续成年门诊患者。采用分离焦虑症状结构化临床访谈（SCI-SAS），按照DSM-5标准诊断SEPAD。使用成人分离焦虑检查表（ASA-27）评估症状严重程度。为了评估创伤暴露，使用了PTSD的SCID-5标准A表格。创伤性事件被编码为直接经历（自我）或涉及亲密的人（他人）。对分离事件的终生暴露也进行了评估。结果：60.4%的参与者被归类为成年期或儿童期无SEPAD (NO-SEPAD)， 18.9%为儿童期发病的SEPAD， 20.8%为成人发病的SEPAD。控制合并症，涉及自我和分离事件的终生创伤事件，涉及他人的创伤事件显著预测成人发病的SEPAD。创伤暴露年龄与SEPAD发病年龄之间存在显著相关性。结论：我们的结果与成人发病的SEPAD可能代表一种事件相关疾病的假设是一致的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Spectrums 医学-精神病学

CiteScore

6.20

自引率

6.10%

发文量

239

审稿时长

>12 weeks

期刊介绍： CNS Spectrums covers all aspects of the clinical neurosciences, neurotherapeutics, and neuropsychopharmacology, particularly those pertinent to the clinician and clinical investigator. The journal features focused, in-depth reviews, perspectives, and original research articles. New therapeutics of all types in psychiatry, mental health, and neurology are emphasized, especially first in man studies, proof of concept studies, and translational basic neuroscience studies. Subject coverage spans the full spectrum of neuropsychiatry, focusing on those crossing traditional boundaries between neurology and psychiatry.