- Last edited on April 30, 2020
Agoraphobia
Primer
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.
Diagnostic Criteria
Criterion A
Marked fear or anxiety about at least 2
of the following 5 situations:
- Public transportation (e.g. - automobiles, buses, trains, ships, planes)
- Open spaces (e.g. - parking lots, malls, marketplaces, bridges)
- Enclosed places (e.g. - rooms, shops, theatres, cinemas)
- Crowds or standing in line
- 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:
- The symptoms are not confined to a specific phobia, situational type
- Social situations (social anxiety disorder)
- Relate exclusively to obsessions (obsessive-compulsive disorder)
- Perceived defects or flaws in physical appearance (body dysmorphic disorder)
- Reminders of traumatic events (post-traumatic stress disorder)
- Fear of separation (separation anxiety disorder).
Treatment
Psychotherapy
CBT is the treatment of choice.
Medications
SSRIs and SNRIs are recommended. Anxiolytics are not recommended.