Although separation anxiety disorder is recognized as a diagnostic category in the DSM-IV-TR only for childhood, an adult form of the disorder with a lifetime prevalence of 6.6% has also been described.

In the present study we investigated, in a group of stabilized outpatients, the frequency of adult separation anxiety disorder (ASAD) as well as its clinical correlates and attachment styles.

Patients with and without ASAD were compared on several clinical indices as well as on attachment styles. The associations of separation anxiety with psychopathology and attachment were investigated by means of multiple regression analysis.

Thirty-six patients out of 53 were categorized as having ASAD. Three of them had no other axis I psychiatric disorder. Fourteen ASAD patients had an history of childhood separation anxiety disorder (CSAD). As compared with those without ASAD, patients with ASAD showed: higher frequency of alexithymia and higher scores on the “difficulty identifying feelings”; worse social functioning; greater behavioral inhibition during childhood; worse reaction to loss events; higher scores on insecure attachment styles. Independent predictors of the intensity of ASAD symptoms were an “anxious-ambivalent” attachment style, lifetime symptoms of panic disorder, difficulties in identifying feelings and behavioral inhibition during childhood.

Our findings suggest that ASAD can both represent the evolution of a CSAD or be a primary condition in adulthood. The presence of ASAD in patients with mood or anxiety disorders is associated to insecure attachment styles, alexithymia, and impairment of social functioning.