Pediatric-onset and adult-onset separation anxiety disorder across countries in the world mental health survey

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• dc.contributor.author Silove, Derrick
• dc.contributor.author Alonso Caballero, Jordi
• dc.contributor.author Bromet, Evelyn J.
• dc.contributor.author Gruber, Mike
• dc.contributor.author Sampson, Nancy A.
• dc.contributor.author Andrade, Laura Helena
• dc.contributor.author Benjet, Corina
• dc.contributor.author Caldas de Almeida, José Miguel
• dc.contributor.author Girolamo, Giovanni de
• dc.contributor.author Jonge, Peter de
• dc.contributor.author Demyttenaere, Koen
• dc.contributor.author Fiestas, Fabian
• dc.contributor.author Florescu, Silvia
• dc.contributor.author Gureje, Oye
• dc.contributor.author He, Yanling
• dc.contributor.author Karam, Elie G.
• dc.contributor.author Lepine, Jean-Pierre
• dc.contributor.author Murphy, Sam
• dc.contributor.author Villa-Posada, Jose
• dc.contributor.author Zarkov, Zahari
• dc.contributor.author Kessler, Ronald C.
• dc.date.accessioned 2018-12-13T08:54:49Z
• dc.date.available 2018-12-13T08:54:49Z
• dc.date.issued 2015
• dc.description.abstract OBJECTIVE: The age-at-onset criterion for separation anxiety disorder was removed in DSM-5, making it timely to examine the epidemiology of separation anxiety disorder as a disorder with onsets spanning the life course, using cross-country data. METHOD: The sample included 38,993 adults in 18 countries in the World Health Organization (WHO) World Mental Health Surveys. The WHO Composite International Diagnostic Interview was used to assess a range of DSM-IV disorders that included an expanded definition of separation anxiety disorder allowing onsets in adulthood. Analyses focused on prevalence, age at onset, comorbidity, predictors of onset and persistence, and separation anxiety-related role impairment. RESULTS: Lifetime separation anxiety disorder prevalence averaged 4.8% across countries (interquartile range [25th-75th percentiles]=1.4%-6.4%), with 43.1% of lifetime onsets occurring after age 18. Significant time-lagged associations were found between earlier separation anxiety disorder and subsequent onset of internalizing and externalizing DSM-IV disorders and conversely between these disorders and subsequent onset of separation anxiety disorder. Other consistently significant predictors of lifetime separation anxiety disorder included female gender, retrospectively reported childhood adversities, and lifetime traumatic events. These predictors were largely comparable for separation anxiety disorder onsets in childhood, adolescence, and adulthood and across country income groups. Twelve-month separation anxiety disorder prevalence was considerably lower than lifetime prevalence (1.0% of the total sample; interquartile range=0.2%-1.2%). Severe separation anxiety-related 12-month role impairment was significantly more common in the presence (42.4%) than absence (18.3%) of 12-month comorbidity. CONCLUSIONS: Separation anxiety disorder is a common and highly comorbid disorder that can have onset across the lifespan. Childhood adversity and lifetime trauma are important antecedents, and adverse effects on role function make it a significant target for treatment.
• dc.description.sponsorship The World Health Organization (WHO) World Mental Health Survey Initiative is supported by NIMH (R01 MH070884, R13 MH066849, and R01 MH069864), the National Institute on Drug Abuse (R01 DA016558), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation and the Fogarty International Center (FIRCA R03-TW006481). The São Paulo Megacity Mental Health Survey is supported by the State of São Paulo Research Foundation Thematic Project (grant 03/00204-3). The ESEMeD project is funded by the European Commission (contracts QLG5-1999-01042, SANCO 2004123, and EAHC 20081308), the Piedmont Region (Italy), Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spain (FIS 00/0028), Ministerio de Ciencia y Tecnología, Spain (SAF 2000-158-CE), Departament de Salut, Generalitat de Catalunya, Spain, Instituto de Salud Carlos III (CIBER CB06/02/0046, RETICS RD06/0011 REM-TAP). The Lebanese National Mental Health Survey (L.E.B.A.N.O.N.) is supported by the Lebanese Ministry of Public Health, WHO (Lebanon), National Institutes of Health/Fogarty International Center (R03 TW006481-01). The U.S. National Comorbidity Survey Replication is supported by NIMH (U01-MH60220), with supplemental support from the National Institute of Drug Abuse, the Substance Abuse and Mental Health Services Administration, the Robert Wood Johnson Foundation (grant 044708)
• dc.format.mimetype application/pdf
• dc.identifier.citation Silove D, Alonso J, Bromet E, Gruber M, Sampson N, Scott K et al. Pediatric-onset and adult-onset separation anxiety disorder across countries in the world mental health survey. Am J Psychiatry. 2015 Jul;172(7):647-56. DOI: 10.1176/appi.ajp.2015.14091185
• dc.identifier.doi http://dx.doi.org/10.1176/appi.ajp.2015.14091185
• dc.identifier.issn 0002-953X
• dc.identifier.uri http://hdl.handle.net/10230/36053
• dc.language.iso eng
• dc.publisher American Psychiatric Publishing
• dc.relation.ispartof American Journal of Psychiatry. 2015 Jul;172(7):647-56
• dc.rights © American Psychiatric Association ALL RIGHTS RESERVED
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.other Ansietat
• dc.subject.other Salut global
• dc.title Pediatric-onset and adult-onset separation anxiety disorder across countries in the world mental health survey
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion