Relationships between depersonalization-derealization symptoms and separation anxiety in adult patients with mood and anxiety disorders
Front Psychiatry. 2025 May 8;16:1565217. doi: 10.3389/fpsyt.2025.1565217. eCollection 2025.
ABSTRACT
AIMS: To establish the relationship between depersonalization/derealization symptoms (DPs), as assessed by different standardized DP scales, and separation anxiety in a sample of outpatients with anxiety and mood disorders as a primary diagnosis (n=156). We hypothesized that patients with high levels of separation anxiety had more frequent, severe, and clinically relevant DP symptoms than those with low levels of separation anxiety.
METHODS: A consecutive sample of 156 outpatients with mood and anxiety disorders was evaluated by the Structured Clinical Interview for Derealization/Depersonalization Spectrum (SCI-DER), the Cambridge Depersonalization Scale (CDS), the Body Sensation Questionnaire (BSQ), the Dissociative Experience Scale (DES), the Panic/Agoraphobic Questionnaire-self report (PAS-SR) for the evaluation of separation anxiety.
RESULTS: The sample was dichotomized into a group with high levels of separation anxiety (3 or more DSM-IV diagnostic items endorsed) vs. those with low levels of separation anxiety (less than 3 items endorsed) by PAS-SR ‘Separation Anxiety’ domain scoring. Patients with high separation anxiety scored significantly higher in all DPs scales compared to the low-separation anxiety group. Derealization was significantly correlated with suicidal ideation (p<.001) and overall suicidality (p<.01). Auto-psychic depersonalization, intended as the feeling unfamiliarity of the self in terms of sensation of being an outside observer of one’s mental process, appeared to exert a significant effect on both suicidality (p<.01) and depression (p<.01).
CONCLUSIONS: Our findings highlight a link between separation anxiety and DP symptoms. This connection contributes to understanding and evaluating suicidality in individuals with mood and anxiety disorders.
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