Childhood Separation Anxiety Disorder and Panic Disorder: Differences Between Respiratory and Nonrespiratory Subtypes

Objective: The association between childhood separation anxiety disorder (CSAD) and panic disorder (PD) has been demonstrated, although some findings are contradictory. The separation anxiety hypothesis postulates that both CSAD and PD encompass a heightened sensitivity to carbon dioxide (CO₂). Patients with the respiratory subtype (RS) of PD are known to be more sensitive to CO₂ than those from the nonrespiratory subtype (NRS). Therefore, the primary objective centered on the comparative analysis of CSAD prevalence between RS and NRS groups, with secondary objectives focusing on the comparative assessment of RS and NRS groups and the control group.

Methods: Sixty RS-PD patients, 60 NRS-PD patients, and 60 controls were assessed for retrospective diagnosis of CSAD between March 2020 and August 2023 using a diagnostic categorical instrument, DSM-5 criteria, and a dimensional one, the Separation Anxiety Symptom Inventory.

Results: RS patients had a significantly greater history of CSAD (55%) compared to the NRS (23%) and control (17%) groups (P < .001), which shows stronger association with the RS group. As seen in logistic regression, RS patients had 3.02 more chances of having CSAD when compared the NRS group and 5.11 when compared to the control group, which shows stronger association with the RS group.

Conclusion: This study supports the hypothesis that RS-PD is associated with CSAD, while there is a weak association between NRS-PD and CSAD. It is advisable for clinicians to screen individuals with RS-PD for symptoms of separation anxiety, as these symptoms may have a negative impact on the prognosis of PD.

Prim Care Companion CNS Disord 2024;26(5):24m03709.

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