{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:34:41Z","timestamp":1764333281440,"version":"3.40.5"},"reference-count":49,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T00:00:00Z","timestamp":1681257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Early Intervention Psych"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aimed to investigate whether separation anxiety (SA) constitutes a dimension related to age at onset of panic disorder (PD), in homogeneous subgroups of outpatients with PD, based on their age of onset and symptom severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A sample of 232 outpatients with PD was assessed with the Panic Disorder Severity Scale (PDSS) and the Sheehan Disability Scale (SDS) for functional impairments. Separation anxiety was evaluated using structured interviews and questionnaires. We applied a K\u2010Means Cluster Analysis based on the standardized \u201cPD age of onset\u201d and \u201cthe PDSS total score\u201d to identify distinct but homogeneous groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified three groups of patients: group 1 (\u201cPD early onset\/severe\u201d, <jats:italic>N<\/jats:italic>\u2009=\u200997, 42%, onset 23.2\u2009\u00b1\u20096.7\u2009years), group 2 (\u201cPD early onset\/not severe\u201d, <jats:italic>N<\/jats:italic>\u2009=\u200976, 33%, onset 23.4\u2009\u00b1\u20096.0\u2009years) and group 3 (\u201cPD adult onset\/not severe\u201d, <jats:italic>N<\/jats:italic>\u2009=\u200959, 25%, onset 42.8\u2009\u00b1\u20097.0\u2009years). Patients with early onset\/severe PD had significantly higher scores on all SA measures than PD late\u2010onset\/not severe. Regression analyses showed that SA scores, but not PDSS scores, were predictive of impairment in SDS work\/school, social life, and family functioning domains.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our data indicate a significant relationship between SA and PD with an earlier age of onset and an impact on individual functioning. This may have important implications for implementing preventive interventions targeting early risk factors for the subsequent onset of PD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eip.13419","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T06:19:41Z","timestamp":1681366781000},"page":"1172-1179","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The relationship of separation anxiety with the age of onset of panic disorder"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9092-9144","authenticated-orcid":false,"given":"Stefano","family":"Pini","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Pisa  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Milrod","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine PRIME, (Psychiatric Research Institute of Montefiore Einstein)  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David S.","family":"Baldwin","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Sciences, Faculty of Medicine, Academic Centre, College Keep University of Southampton  Southampton UK"},{"name":"Department of Psychiatry and Mental Health University of Cape Town  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam A.","family":"Schiele","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy Medical Center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg  Freiburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele","family":"Massimetti","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Pisa  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Pisa  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Martini","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Pisa  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Borwin","family":"Bandelow","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy University Medical Center Gottingen  G\u00f6ttingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Domschke","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy Medical Center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg  Freiburg Germany"},{"name":"Center for Basics in NeuroModulation, Faculty of Medicine University of Freiburg  Freiburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna","family":"Abelli","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Pisa  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. (2022).Diagnostic and statistical manual of mental disorders. (5th ed. text rev.)https:\/\/doi.org\/10.1176\/appi.books.9780890425787","DOI":"10.1176\/appi.books.9780890425787"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674370104601007"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/15622975.2016.1190867"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.152.9.1362"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003065115607491"},{"issue":"6","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1176\/ajp.154.6.27","article-title":"The panic\u2010agoraphobic spectrum: A descriptive approach to the assessment and treatment of subtle symptoms","volume":"154","author":"Cassano G. B.","year":"1997","journal-title":"The American Journal of Psychiatry"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000224"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S55220"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3956(01)00051-6"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20931"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0706743716640757"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2021.03.021"},{"volume-title":"Structured clinical interview for the DSM\u2010IV axis I disorders: SCID\u2010I\/P, version 2.0","year":"1997","author":"First M. B.","key":"e_1_2_10_14_1"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291710000553"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20681"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20631"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852914000807"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000284078"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002826-199518002-00003"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2009.186"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/10503307.2020.17844"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1993.01820160076009"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002826-199518002-00003"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2022.102533"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2012.12070893"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1053\/comp.2003.50024"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2013.13060781"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-0327(91)90077-6"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.20m13299"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2009.01480.x"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2014.06.010"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2007.07.029"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.21931"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/hup.2452"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2008.04.002"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001270050177"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1080\/00031305.1990.10475712"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2020.01.009"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2021.08.265"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.2006.163.6.1074"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.154.11.1571"},{"key":"e_1_2_10_43_1","first-page":"151","volume-title":"The anxiety disease and how to overcome it","author":"Sheehan D. V.","year":"1983"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1996.tb09806.x"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2015.14091185"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.3109\/00048679309075806"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-021-01161-7"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2013.09.001"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2019.07.022"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0039373"}],"container-title":["Early Intervention in Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eip.13419","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T03:02:36Z","timestamp":1712286156000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/eip.13419"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,12]]},"references-count":49,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1111\/eip.13419"],"URL":"https:\/\/doi.org\/10.1111\/eip.13419","archive":["Portico"],"relation":{},"ISSN":["1751-7885","1751-7893"],"issn-type":[{"type":"print","value":"1751-7885"},{"type":"electronic","value":"1751-7893"}],"subject":[],"published":{"date-parts":[[2023,4,12]]},"assertion":[{"value":"2022-04-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}