Purpose of the study: Separation Anxiety Disorder (SEPAD) is highly prevalent among subjects with Panic Disorder (PD) and it has been recently shown to predict poor response to psychophar- macological treatment for PD [1]. We aim to test the hypothesis that SEPAD is correlated to subthreshold mood symptoms which may explain the worse treatment outcomes of PD patients with concomitant SEPAD.Methods: 235 adult outpatients with PD were assessed with the SCID-I, the Panic Disorder Severity Scale (PDSS), the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS) and the Adult Separation Anxiety Questionnaire (ASA-27). In addition, subjects were evaluated with the Mood Spectrum Self- Report Instrument (MOODS-SR, lifetime version), which pro- vides a rating for major affective symptoms, but also identifies and rates atypical and mild symptomatic manifestations as expression of sub-clinical conditions [2]. MOODS-SR includes 161 items organized in 3 manic/hypomanic and 3 depressive domains (ex- ploring respectively mood, energy and cognition). The sum of the scores on the 3 manic domains constitutes the ‘manic component’ and that of the 3 depressive domains the ‘depressive component’. Summary of results: 125 (53.2%) subjects were categorized as having SEPAD and 110 (46.8%) as not. As shown in Ta- ble 1, groups did not differ for lifetime prevalence of Obses- sive Compulsive Disorder (OCD), Social Phobia, Simple Phobia, Bipolar Disorder (BD) type I and type II or Major Depressive Disorder (MDD). SEPAD subjects showed higher total, manic and depressive component scores on the MOODS-SR. In the overall sample, ASA-27 score was correlated to MOODS-SR total, manic/hypomanic and depressive component scores. The MOODS-SR manic/hypomanic component was correlated to the ASA-27 score even controlling for age, gender, presence of BD and MDD and severity of PD. Conclusions: SEPAD is highly prevalent among subjects with PD. Moreover, SEPAD is not associated with any specific mood diagnosis. However, the presence of SEPAD is correlated to high subthreshold mood symptoms. Specifically, the severity of separation anxiety symptoms is positively correlated with a manic/hypomanic mood component. It is possible that PD patients who show features of SEPAD are vulnerable to experiencing a subthreshold mood constellation (e.g. mood lability and cyclothymic temperament). From this perspective, the presence of SEPAD might direct clinical attention to those persons with PD who are most likely to endorse a soft bipolar spectrum of symptoms. In light of our data, SEPAD should be routinely evaluated among PD patients in order to inform treatment choices. More- over, further investigations will be needed to confirm these find- ings and to address whether this mood diathesis may at least in part explain the worse treatment outcomes found in PD patients with comorbid SEPAD.References [1] Miniati, M., Calugi, S., Rucci, P., Shear, M.K., Benvenuti, A., San- toro, D., Mauri, M., Cassano, G.B., 2012. Predictors of response among patients with panic disorder treated with medications in a naturalistic follow-up: the role of adult separation anxiety. J. Affect. Disord. 136, 675−9. [2] Dell’Osso, L., Armani, A., Rucci, P., Frank, E., Fagiolini, A., Cor- retti, G., Shear, M.K., Grochocinski, V.J., Maser, J.D., Endicott, J., Cas- sano, G.B. 2002. Measuring mood spectrum: Comparison of interview (SCI-MOODS) and self-report (MOODS-SR) instruments. Compr. Psy- chiatry. 43, 69−73.
P.4.b.015 Separation anxiety and mood symptoms among patients with panic disorder
GESI, CAMILLA;ABELLI, MARIANNA;PINI, STEFANO
2014-01-01
Abstract
Purpose of the study: Separation Anxiety Disorder (SEPAD) is highly prevalent among subjects with Panic Disorder (PD) and it has been recently shown to predict poor response to psychophar- macological treatment for PD [1]. We aim to test the hypothesis that SEPAD is correlated to subthreshold mood symptoms which may explain the worse treatment outcomes of PD patients with concomitant SEPAD.Methods: 235 adult outpatients with PD were assessed with the SCID-I, the Panic Disorder Severity Scale (PDSS), the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS) and the Adult Separation Anxiety Questionnaire (ASA-27). In addition, subjects were evaluated with the Mood Spectrum Self- Report Instrument (MOODS-SR, lifetime version), which pro- vides a rating for major affective symptoms, but also identifies and rates atypical and mild symptomatic manifestations as expression of sub-clinical conditions [2]. MOODS-SR includes 161 items organized in 3 manic/hypomanic and 3 depressive domains (ex- ploring respectively mood, energy and cognition). The sum of the scores on the 3 manic domains constitutes the ‘manic component’ and that of the 3 depressive domains the ‘depressive component’. Summary of results: 125 (53.2%) subjects were categorized as having SEPAD and 110 (46.8%) as not. As shown in Ta- ble 1, groups did not differ for lifetime prevalence of Obses- sive Compulsive Disorder (OCD), Social Phobia, Simple Phobia, Bipolar Disorder (BD) type I and type II or Major Depressive Disorder (MDD). SEPAD subjects showed higher total, manic and depressive component scores on the MOODS-SR. In the overall sample, ASA-27 score was correlated to MOODS-SR total, manic/hypomanic and depressive component scores. The MOODS-SR manic/hypomanic component was correlated to the ASA-27 score even controlling for age, gender, presence of BD and MDD and severity of PD. Conclusions: SEPAD is highly prevalent among subjects with PD. Moreover, SEPAD is not associated with any specific mood diagnosis. However, the presence of SEPAD is correlated to high subthreshold mood symptoms. Specifically, the severity of separation anxiety symptoms is positively correlated with a manic/hypomanic mood component. It is possible that PD patients who show features of SEPAD are vulnerable to experiencing a subthreshold mood constellation (e.g. mood lability and cyclothymic temperament). From this perspective, the presence of SEPAD might direct clinical attention to those persons with PD who are most likely to endorse a soft bipolar spectrum of symptoms. In light of our data, SEPAD should be routinely evaluated among PD patients in order to inform treatment choices. More- over, further investigations will be needed to confirm these find- ings and to address whether this mood diathesis may at least in part explain the worse treatment outcomes found in PD patients with comorbid SEPAD.References [1] Miniati, M., Calugi, S., Rucci, P., Shear, M.K., Benvenuti, A., San- toro, D., Mauri, M., Cassano, G.B., 2012. Predictors of response among patients with panic disorder treated with medications in a naturalistic follow-up: the role of adult separation anxiety. J. Affect. Disord. 136, 675−9. [2] Dell’Osso, L., Armani, A., Rucci, P., Frank, E., Fagiolini, A., Cor- retti, G., Shear, M.K., Grochocinski, V.J., Maser, J.D., Endicott, J., Cas- sano, G.B. 2002. Measuring mood spectrum: Comparison of interview (SCI-MOODS) and self-report (MOODS-SR) instruments. Compr. Psy- chiatry. 43, 69−73.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
