Manicavasagar V, Silove D, Curtis J
Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales at Liverpool Hospital, Australia.
Compr Psychiatry. 1997 Sep-Oct;38(5):274-82. doi: 10.1016/s0010-440x(97)90060-2.
Separation anxiety disorder is well recognized as a juvenile psychiatric disorder, but it appears to be rarely diagnosed in adulthood. Drawing on our clinical impressions and a review of the relevant literature, we sought to investigate whether separation anxiety symptoms could be identified in adulthood. Forty-four subjects recruited by a media campaign were administered a semistructured interview and a self-report checklist for adult separation anxiety (ASA) symptoms, as well as the Separation Anxiety Symptom Inventory (SASI), a retrospective measure of early separation anxiety symptoms. Diagnoses of major depressive disorder (MDD), panic disorder (PD), agoraphobia (Ag), and dependent personality disorder were made using the SCID-P and SCID-II. Thirty-six subjects met criteria for a putative diagnosis of ASA based on a global clinical rating and/or endorsement of DSM-IV-derived criteria. Although most subjects dated the separation anxiety symptoms to their juvenile years, it was notable that one third reported the first onset of separation anxiety symptoms in adulthood. Although comorbid lifetime anxiety or depressive disorders were common, the majority of subjects reported that the separation anxiety symptoms predated other axis I disorders. Only six subjects (17%) were diagnosed with dependent personality disorder. Although limited by the method of sampling, this preliminary study suggests the need to examine more systematically whether a form of separation anxiety disorder may occur in adulthood.
分离焦虑症被公认为一种青少年精神障碍,但在成年人中似乎很少被诊断出来。基于我们的临床印象以及对相关文献的回顾,我们试图调查成年期是否能识别出分离焦虑症状。通过媒体宣传招募的44名受试者接受了半结构化访谈、一份关于成人分离焦虑(ASA)症状的自我报告清单,以及分离焦虑症状量表(SASI),这是一种对早期分离焦虑症状的回顾性测量方法。使用SCID-P和SCID-II对重度抑郁症(MDD)、惊恐障碍(PD)、广场恐惧症(Ag)和依赖型人格障碍进行诊断。36名受试者根据总体临床评分和/或对DSM-IV衍生标准的认可,符合ASA推定诊断标准。尽管大多数受试者将分离焦虑症状追溯到青少年时期,但值得注意的是,三分之一的受试者报告分离焦虑症状首次出现在成年期。虽然共病终生焦虑或抑郁障碍很常见,但大多数受试者报告分离焦虑症状早于其他轴I障碍出现。只有6名受试者(17%)被诊断为依赖型人格障碍。尽管受抽样方法的限制,但这项初步研究表明有必要更系统地研究成年期是否可能出现某种形式的分离焦虑症。