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 youngerchildren who are extremely unwilling to separate from majorattachment figures (e.g., parents, grandparents, older siblings)or from home.¹ Separation anxiety disorder can dramatically affecta child’s life and his parent’s life by limiting the ability toengage in ordinary activities, for example, regular school attendancedue to excessive worry about potential harm toward oneselfor one’s primary caregivers. School refusal is reported inabout 75% of children with separation anxiety disorder, andvice versa, separation anxiety disorder is reported in about 80%of children with school refusal.²