A 6-year-old girl refuses to attend school and cries inconsolably when separated from her mother. She repeatedly complains of stomachaches and headaches on school mornings, which resolve on weekends. She fears that something bad will happen to her mother if they are apart, and sleeps only in her mother's bed. Symptoms have persisted for 5 months. What is the most likely diagnosis?
- A Social anxiety disorder
- B Generalized anxiety disorder
- C Separation anxiety disorder ✓
- D Adjustment disorder with anxious mood
Correct answer: C. Separation anxiety disorder
Explanation
Separation anxiety disorder requires excessive fear concerning separation from attachment figures lasting at least 4 weeks in children, with refusal to attend school, physical complaints on school days, nightmares about separation and reluctance to sleep away from the caregiver. Social anxiety disorder centers on fear of scrutiny by peers, not separation itself. Generalized anxiety involves worry across many domains, and adjustment disorder follows an identifiable stressor within 3 months, neither of which fits this picture.
Reference: Nelson Textbook of Pediatrics, 22nd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.