Separation Anxiety Disorder and School Refusal in Childhood: Potential Risk Factors for Developing Distinct Psychiatric Disorders?

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Sir: Separation anxiety disorder refers typically to younger children who are extremely unwilling to separate from major attachment figures (e.g., parents, grandparents, older siblings) or from home.1 Separation anxiety disorder can dramatically affect a child’s life and his parent’s life by limiting the ability to engage in ordinary activities, for example, regular school attendance due to excessive worry about potential harm toward oneself or one’s primary caregivers. School refusal is reported in about 75% of children with separation anxiety disorder, and vice versa, separation anxiety disorder is reported in about 80% of children with school refusal.2

Prim Care Companion J Clin Psychiatry 2008;10(1):72-73 [letter]