Objective: To examine the association between separation anxiety disorder (SAD) and mental disorders in a community sample and to evaluate whether separation anxiety is specifically related to panic disorder with and without agoraphobia. Method: The data come from a 4-year, prospective longitudinal study of a representative cohort of adolescents and young adults aged 14–24 years at baseline in Munich, Germany. The present analyses are based on a subsample of the younger cohort that completed baseline and two follow-up investigations (n = 1,090). DSM-IV diagnoses were made using the Munich Composite International Diagnostic Interview. Cox regressions with time-dependent covariates were used to examine whether prior SAD is associated with an increased risk for subsequent mental disorders. Results: Participants meeting DSM-IV criteria for SAD were at an increased risk of developing subsequent panic disorder with agoraphobia (PDAG) (HR = 18.1, 95% CI = 5.6–58.7), specific phobia (HR = 2.7, 95% CI = 1.001–7.6), generalized anxiety disorder (HR = 9.4, 95% CI = 1.8–48.7), obsessive-compulsive disorder (HR = 10.7, 95% CI = 1.7–66.1), bipolar disorder (HR = 7.7, 95% CI = 2.8–20.8), pain disorder (HR = 3.5, 95% CI = 1.3–9.1), and alcohol dependence (HR = 4.7, 95% CI = 1.7–12.4). Increased hazard rates for PDAG (HR = 4.2, 95% CI = 1.4–12.1), bipolar disorder type II (HR = 8.1, 95% CI = 2.3–27.4), pain disorder (HR = 1.9, 95% CI = 1.01–3.5), and alcohol dependence (HR = 2.1, 95% CI = 1.1–4.) were also found for subjects fulfilling subthreshold SAD. Conclusions: Although revealing a strong association between SAD and PDAG, our results argue against a specific SAD-PDAG relationship. PDAG was neither a specific outcome nor a complete mediator variable of SAD.

Les élèves des écoles maternelles et élémentaires sont évalués. En cas de suspicion de troubles des apprentissages, ils sont adressés dans une unité d'évaluations pour une expertise médicalisée. Cette recherche porte sur la manière dont ce dispositif a pris place dans celui de l'école dans le but de traiter ces éventuels troubles des apprentissages. Car, ces enfants semblent enlisés dans des procédés d'apprentissages repérables chez des enfants de maternelle et de cours préparatoire. Les apports de la psychologie du développement nous permettent de les décrire, mais ne nous éclairent pas sur l'articulation entre les développements cognitif et affectif. C'est donc au regard des apports de la psychopathologie clinique et de la psychanalyse, en nous appuyant sur des études de cas, que nous traitons de ces problématiques interférant sur les apprentissages scolaires. À partir de là nous interrogeons la pertinence du dispositif médical pour le traitement de la difficulté scolaire. / The pupils of preschool and elementary school are estimated. In case of suspicion of possible leaming disorders they are sent in a unit of evaluation for a medical expertise. This research suggests examining how the medical device has come in that of the school to detect at thepupil's of possible leaming disorders and treat them. Yet these children seem to stay in processes of leaming which are the ones of children of preschool and first year of elementary school. The contributions theories of cognitive development allow us to describe them, but does not enlight us about the articulation between the cognitive and emotional development. lt is therefore, based on the contributions of the clinical psychopathology and the psychoanalysis, based on several case studies, that we treat problems susceptible to interfere on the school leaming. From there we question the relevance of the medical device for the treatment of the school difficulty.