Separation Anxiety Disorder in Youth With Mitral Valve Prolapse: Associations With Parental Attitudes and Anxiety Sensitivity

OBJECTIVES: Mitral valve prolapse (MVP) is generally benign in youth but is often accompanied by somatic sensations that resemble anxiety symptoms. This study examined the prevalence and severity of separation anxiety disorder in children and adolescents with MVP and explored associations with parental attitudes and anxiety sensitivity (AS). METHODS: Sixty-five youth with MVP (ages 7-18 years) and 60 age-matched healthy controls underwent structured cardiologic and mental health evaluation. Diagnoses were established using the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. Validated scales assessed separation anxiety symptoms, parental attitudes, and AS. RESULTS: Separation anxiety disorder prevalence and symptom severity were significantly higher in the MVP group than in controls ( p < 0.001). Parents of children with MVP reported higher levels of overprotection. AS did not differ significantly between groups. Mitral regurgitation jet length correlated positively with physical AS ( p = 0.043) and negatively with perceived maternal emotional warmth ( p = 0.026). In a parsimonious multivariable model, only physical AS independently predicted separation anxiety severity. CONCLUSION: Youth with MVP exhibit elevated separation anxiety, suggesting that somatic cues linked to benign cardiac findings may interface with family context to increase separation-related vulnerability. Integrating mental health assessment into routine pediatric cardiology care may facilitate early identification and intervention.