Separation anxiety disorder among outpatients with major depressive disorder: Prevalence and clinical correlates

Elbay R. Y., Görmez A., Kılıç A., Avcı S. H.

Comprehensive Psychiatry, vol.105, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 105
  • Publication Date: 2021
  • Doi Number: 10.1016/j.comppsych.2020.152219
  • Journal Name: Comprehensive Psychiatry
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, PASCAL, BIOSIS, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Psycinfo, Directory of Open Access Journals
  • Keywords: Comorbidity, Depression, Prevalence, Separation anxiety
  • Istanbul Medipol University Affiliated: Yes


Prior studies have reported that separation anxiety disorder (SEPAD) can continue into or may begin in adulthood. Association of SEPAD with other psychiatric disorders has been frequently examined, and high rates of comorbidities have been found. The aim of this study was to investigate the prevalence and clinical correlation of SEPAD in adult patients undergoing treatment for major depressive disorder (MDD). The study sample was comprised of 100 outpatients. Participants underwent a DSM-5-based comprehensive assessment. Purposefully-designed semi-structured sociodemographic information and illness history forms were filled out by the researchers, and diagnoses of SEPAD were made using the Structured Clinical Interview for Separation Anxiety Symptoms, Separation Anxiety Symptom Inventory and Adult Separation Anxiety Survey. The frequency of SEPAD was 41% in patients with MDD, three-quarters of whom were adult onset. The use of new-generation antidepressants, adjunctive medications and comorbidity of other anxiety disorders were higher in patients with SEPAD (p < 0.05). SEPAD was highly prevalent, with a majority of cases starting in adulthood among patients with MDD, while SEPAD comorbidity was associated with high levels of anxiety and an increased likelihood of suboptimal response to usual depression treatment. Further studies are required to define the relevance and pathological basis for the comorbidity of SEPAD in people with MDD.