Clinical correlates and significance of separation anxiety in patients with bipolar disorder

Pini, Stefano; Abelli, Marianna; Mauri, Mauro; Muti, Matteo; Iazzetta, Paolo; Banti, S.; Cassano, Giovanni Battista

doi:10.1111/j.1399-5618.2005.00216.x

Cited by 42 publications

(34 citation statements)

References 30 publications

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“…One finding that warrants particular attention is the strong association between SAD and bipolar disorders, as only two studies have so far reported an SAD-bipolar link [40, 41]. It is notable that in the latter clinical trial the highest rate of childhood SAD was found among bipolar patients with an additional PDAG diagnosis (50%) and that this rate was considerably higher than among pure bipolar (25.8%) and pure PDAG patients (4.2%).…”

Section: Discussionmentioning

confidence: 83%

Childhood Separation Anxiety and the Risk of Subsequent Psychopathology: Results from a Community Study

Brückl

Wittchen

Höfler

et al. 2006

Psychother Psychosom

145

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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.

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Section: Discussionmentioning

confidence: 83%

Childhood Separation Anxiety and the Risk of Subsequent Psychopathology: Results from a Community Study

Brückl

Wittchen

Höfler

et al. 2006

Psychother Psychosom

145

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“…This temperamental profile is associated to a particular sensitivity to the separation anxiety. Moreover, the relationship between cyclothymic affective instability, separation anxiety as well as increased sensitivity to rejection in interpersonal context (closely related to mood reactivity) has been clearly confirmed by different research group Pini, Abelli et al 2005).…”

Section: Discussionmentioning

confidence: 83%

“…As expected, cyclothymic subjects presented the highest scores in cyclothymic temperament. Previous studies observed that separation anxiety [49] and interpersonal rejection sensitivity are strongly related to cyclothymic mood reactivity [19,50,51]. In a study of patients who met DSM-IV criteria for Major Depressive Disorder (MDD) with atypical features, Akiskal et al [52] reported that the ones with a comorbidity with panic attacks exhibited a markedly significant cyclothymic temperamental disposition, as well as a higher number of past hypomanic episodes and stressors.…”

Section: Clinical Featuresmentioning

confidence: 99%

Impulsivity in anxiety disorders

Carlo

Benvenuti

Dima

et al. 2012

International Clinical Psychopharmacology

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“…Persons with separation anxiety symptoms constantly look for protection and reassurance, and tend to develop close and emotionally intense relationships characterized by a high level of dependence. Analogously to behavioral inhibition [12] , separation anxiety can be conceptualized as an intermediate phenotype of anxiety proneness that cuts across clinical diagnostic labels, as shown by a high rate of co-occurrence with other DSM-IV disorders reported in different studies [10,13,14] . Bipolar disorder is a mood disorder that often presents co-occurring separation anxiety symptoms [14] .…”

Section: Reductions Inmentioning

confidence: 99%

“…Analogously to behavioral inhibition [12] , separation anxiety can be conceptualized as an intermediate phenotype of anxiety proneness that cuts across clinical diagnostic labels, as shown by a high rate of co-occurrence with other DSM-IV disorders reported in different studies [10,13,14] . Bipolar disorder is a mood disorder that often presents co-occurring separation anxiety symptoms [14] . Feelings of abandonment and severe symptoms in the presence of a separation event are frequent in patients with bipolar disorder, especially in connection with situations (either objective or perceived) that threaten their bond and proximity to significant others.…”

Section: Reductions Inmentioning

confidence: 99%

Reductions in Platelet 18-kDa Translocator Protein Density Are Associated with Adult Separation Anxiety in Patients with Bipolar Disorder

Abelli¹,

Chelli²,

Costa³

et al. 2010

Neuropsychobiology

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Background: Recent studies indicate that adult separation anxiety disorder is a discrete diagnostic entity and worthy of attention. Previously, we found a significant association between platelet expression of the 18-kDa translocator protein (TSPO) and adult separation anxiety in patients with panic disorder or major depression. The aim of this study was to explore whether adult separation anxiety might be a factor differentiating TSPO expression in a sample of patients with bipolar disorder. Methods: The equilibrium binding parameters of the specific TSPO ligand [³H]PK 11195 were estimated on the platelet membranes of 24 adult outpatients with a DSM-IV diagnosis of bipolar disorder (with or without separation anxiety disorder) and 14 healthy controls. Patients were assessed by SCID-I, HAM-D, YMRS, the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS-A) and the Adult Separation Anxiety Self-Report Checklist (ASA-27). Results: A significant reduction in mean platelet TSPO density was found in bipolar patients with respect to controls. However, the lower density was only evident in the subgroup of bipolar patients who also fulfilled DSM-IV criteria for adult separation anxiety disorder. Individual TSPO density values correlated significantly and negatively with both SCI-SAS-A and ASA-27 total scores. Conclusions: TSPO expression may be a useful biological marker of adult separation anxiety co-occurring with other anxiety and mood disorders, including bipolar disorder.

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Clinical correlates and significance of separation anxiety in patients with bipolar disorder

Cited by 42 publications

References 30 publications

Childhood Separation Anxiety and the Risk of Subsequent Psychopathology: Results from a Community Study

Childhood Separation Anxiety and the Risk of Subsequent Psychopathology: Results from a Community Study

Impulsivity in anxiety disorders

Reductions in Platelet 18-kDa Translocator Protein Density Are Associated with Adult Separation Anxiety in Patients with Bipolar Disorder

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