Agoraphobia

Not to be confused with Acrophobia.

Agoraphobia
An ancient agora in Delos, Greece—one of the public spaces after which the condition is named.
Pronunciation
SpecialtyPsychiatry, clinical psychology
SymptomsAnxiety in situations perceived to be unsafe, panic attacks[1][2]
ComplicationsDepression, substance use disorder[1]
Duration> 6 months[1]
CausesGenetic and environmental factors[1]
Risk factorsFamily history, stressful event[1]
Differential diagnosisSeparation anxiety, post-traumatic stress disorder, major depressive disorder[1]
TreatmentCognitive behavioral therapy[3]
PrognosisResolution in half with treatment[4]
Frequency1.9% of adults[1]

Agoraphobia[1] is a mental and behavioral disorder,[5] specifically an anxiety disorder characterized by symptoms of anxiety in situations where the person perceives their environment to be unsafe with no easy way to escape.[1] These situations can include public transit, shopping centers, crowds and queues, or simply being outside their home on their own.[1] Being in these situations may result in a panic attack.[2] Those affected will go to great lengths to avoid these situations.[1] In severe cases, people may become completely unable to leave their homes.[2]

Agoraphobia is believed to be due to a combination of genetic and environmental factors. The condition often runs in families, and stressful or traumatic events such as the death of a parent or being attacked may be a trigger.[1] In the DSM-5, agoraphobia is classified as a phobia along with specific phobias and social phobia.[1][3] Other conditions that can produce similar symptoms include separation anxiety, post-traumatic stress disorder, and major depressive disorder.[1] The diagnosis of agoraphobia has been shown to be comorbid with depression, substance abuse, and suicide ideation.[6][7] Without treatment, it is uncommon for agoraphobia to resolve.[1] Treatment is typically with a type of counselling called cognitive behavioral therapy (CBT).[3][8] CBT results in resolution for about half of people.[4] In some instances, those with a diagnosis of agoraphobia have reported taking benzodiazepines and antipsychotics.[6] Agoraphobia affects about 1.7% of adults.[1] Women are affected about twice as often as men. The condition is rare in children, often begins in adolescence or early adulthood, and becomes more common at age 65 or above.[1]

  1. ^ a b c d e f g h i j k l m n o p q American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing, pp. 217–221, 938, ISBN 978-0-89042-555-8
  2. ^ a b c "Agoraphobia". PubMed Health. Retrieved 11 August 2016.
  3. ^ a b c Wyatt RJ, Chew RH (2008). Wyatt's Practical Psychiatric Practice: Forms and Protocols for Clinical Use. American Psychiatric Pub. pp. 90–91. ISBN 978-1-58562-687-8. Archived from the original on 21 August 2016.
  4. ^ a b Craske MG, Stein MB (24 June 2016). "Anxiety". Lancet. 388 (10063): 3048–3059. doi:10.1016/S0140-6736(16)30381-6. PMID 27349358. S2CID 208789585.
  5. ^ Drs; Sartorius N, Henderson A, Strotzka H, Lipowski Z, Yu-cun S, You-xin X, et al. "The ICD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines" (PDF). www.who.int World Health Organization. Microsoft Word. bluebook.doc. pp. 110, 112–3. Archived (PDF) from the original on 17 October 2004. Retrieved 23 June 2021 – via Microsoft Bing.
  6. ^ a b Shin J, Park DH, Ryu SH, Ha JH, Kim SM, Jeon HJ (24 July 2020). "Clinical implications of agoraphobia in patients with panic disorder". Medicine. 99 (30): e21414. doi:10.1097/MD.0000000000021414. ISSN 0025-7974. PMC 7387026. PMID 32791758.
  7. ^ Teismann T, Lukaschek K, Hiller TS, Breitbart J, Brettschneider C, Schumacher U, et al. (24 September 2018). "Suicidal ideation in primary care patients suffering from panic disorder with or without agoraphobia". BMC Psychiatry. 18 (1): 305. doi:10.1186/s12888-018-1894-5. ISSN 1471-244X. PMC 6154913. PMID 30249220.
  8. ^ Pompoli A, Furukawa TA, Imai H, Tajika A, Efthimiou O, Salanti G (13 April 2016). "Psychological therapies for panic disorder with or without agoraphobia in adults: a network meta-analysis". The Cochrane Database of Systematic Reviews. 2016 (4): CD011004. doi:10.1002/14651858.CD011004.pub2. PMC 7104662. PMID 27071857.