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Titolo:
Separation anxiety disorder in children and adolescents - Epidemiology, diagnosis and management
Autore:
Masi, G; Mucci, M; Millepiedi, S;
Indirizzi:
Univ Pisa, Div Child Neurol & Psychiat, IRCCS Stella Maris, I-56018 Pisa, Italy Univ Pisa Pisa Italy I-56018 at, IRCCS Stella Maris, I-56018 Pisa, Italy
Titolo Testata:
CNS DRUGS
fascicolo: 2, volume: 15, anno: 2001,
pagine: 93 - 104
SICI:
1172-7047(2001)15:2<93:SADICA>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
COGNITIVE-BEHAVIORAL TREATMENT; SCHOOL-REFUSING CHILDREN; DSM-III DISORDERS; PANIC DISORDER; CHILDHOOD ANXIETY; PREADOLESCENT CHILDREN; DEPRESSIVE-DISORDERS; REFERRED CHILDREN; LARGE SAMPLE; R DISORDERS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
94
Recensione:
Indirizzi per estratti:
Indirizzo: Masi, G Univ Pisa, Div Child Neurol & Psychiat, IRCCS Stella Maris, Via Giacinti 2, I-56018 Pisa, Italy Univ Pisa Via Giacinti 2 Pisa Italy I-56018 , I-56018 Pisa, Italy
Citazione:
G. Masi et al., "Separation anxiety disorder in children and adolescents - Epidemiology, diagnosis and management", CNS DRUGS, 15(2), 2001, pp. 93-104

Abstract

This paper provides an overview of the phenomenology, longitudinal outcomedata, assessment and management of separation anxiety disorder (SAD) in children and adolescents. SAD is qualitatively different from early worries, and is characterised byan abnormal reactivity to real or imagined separation from attachment figures, which significantly interferes with daily activities and developmentaltasks. Different epidemiological studies indicate a prevalence of 4 to 5% in children and adolescents. In contrast to other anxiety disorders, 50 to 75% of children with SAD come from homes of low socioeconomic status. The severity of symptomatology ranges from anticipatory uneasiness to full-blownanxiety about separation, but children are usually brought to the clinician when SAD results in school refusal or somatic symptoms. School refusal isreported in about 75% of children with SAD, and SAD is reported to occur in up to 80% of children with school refusal. Longitudinal studies have suggested that childhood SAD may be a risk factor for other anxiety disorders, but whether this link is specific to, for example, panic disorder and agoraphobia, or whether SAD represents a general factor of vulnerability for a broad range of anxiety disorders is still debated. Most relevant data are reported on nonpharmacological treatments (psychoeducational, behavioural, cognitive-behavioural, family and psychodynamic), and these are the first choice approach in SAD. Controlled studies show efficacy of cognitive-behavioural therapy in children with anxiety disorders and specifically in SAD-school phobia, supporting this approach as the best proven treatment. Pharmacotherapy should be used in addition to behavioural or psychotherapeutic intervention when the child's symptoms have failed to respond to those treatments, and he/she is significantly impaired by the symptoms. Selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors(SSRI) have a good adverse effect profile and may be considered as first choice drugs in SAD. When different SSRIs fail to improve symptomatology, a trial with a tricyclic antidepressant (TCA) is indicated, with careful monitoring of cardiac functioning. Because of the adverse effect profile and the potential for abuse and dependence, benzodiazepines should be used only when a rapid reduction of symptomatology is needed, until the SSRI or the TCA have begun to be effective (few weeks). Buspirone should be considered inchildren who have not responded to other treatments. Further research is needed to confirm efficacy of newer antidepressants (venlafaxine, mirtazapine, nefazodone) in childhood anxiety disorders.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 09:15:17