May 2019 By PsychDB.com

Agoraphobia

Agoraphobia is an anxiety disorder characterized by symptoms of anxiety in situations where an individual perceives the environment to be unsafe with no easy escape.

Epidemiology

The lifetime prevalence of agoraphobia is 5% in the general population.

Criterion A

Marked fear or anxiety about at least 2 of the following 5 situations:

  1. Public transportation (e.g. - automobiles, buses, trains, ships, planes)
  2. Open spaces (e.g. - parking lots, malls, marketplaces, bridges)
  3. Enclosed places (e.g. - rooms, shops, theatres, cinemas)
  4. Crowds or standing in line
  5. Being outside of home alone
Criterion B

The individual fears or avoids these situations because of thoughts that (1) escape might be difficult or (2) help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms (e.g. - fear of falling or fear of incontinence in the elderly).

Criterion C

The agoraphobic situations almost always provoke fear or anxiety

Criterion D

The agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety.

Criterion E

The fear or anxiety is out of proportion to the actual danger posed by the agoraphobic situations and to the sociocultural context.

Criterion F

The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.

Criterion G

The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning

Criterion H

If another medical condition (e.g. - inflammatory bowel disease, Parkinson’s disease) is present, the fear, anxiety, or avoidance is clearly excessive.

Criterion I

The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder:

Note: Agoraphobia is diagnosed irrespective of the presence of panic disorder. If an individual’s presentation meets criteria for panic disorder and agoraphobia, both diagnoses should be assigned.

Psychotherapy

CBT is the treatment of choice.

Medications

SSRIs and SNRIs are recommended. Anxiolytics are not recommended.

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