Agoraphobia Flashcards
Agoraphobia - dx
A. Marked fear or anxiety about two (or more) of the following five situations:
1. Using public transport (e.g. cars, buses, trains, ships, planes)
2. Being in open spaces (e.g. parking lots, marketplaces, bridges)
3. Being in enclosed spaces (e.g. shops, theatres, cinemas)
4. Standing in line or being in a crowd
5. Being outside the home alone
B. The individual fears or avoids these situations bc of thoughts that might be difficult or help might not be available in the event of developing panic-like symptoms or embarrassing symptoms (e.g. fear of falling in the elevator; fear of incontinence)
C. The agoraphobic situations almost always provoke fear/anxiety
D. The situations are actively avoided, require the presence of a companion or are endured with intense fear or anxiety
E. The fear or anxiety is out of proportion to the actual danger posed by the situation/sociocultural context
F. The fear, anxiety or avoidance is persistent, typically lasting for >6mo
G. Causes clinically significant distress or impairment in functioning (social, occupational or other)
H. If another medical condition is presence, the fear, anxiety or avoidance is clearly excessive
I. Not better explained by the symptoms of another mental disorder - e.g. specific phobia, social anxiety disorder, OCD, body dysmorphic disorder, PTSD, separation anxiety disorder
Note: agoraphobia is dx irrespective of the presence of panic disorder. If an individual’s presentation meets criteria for panic disorder and agoraphobia, both diagnoses should be assigned
Agoraphobia - mx (3)
The majority of people with agoraphobia (90%) develop this as a response to the onset of recurrent panic attacks
- Control panic attacks
- Once anxiety is sufficiently reduced, behavioural therapy with graduated in vivo exposure (direct confrontation of fears under guidance of therapist) to overcome phobic avoidance
__ - If agoraphobia develops without associated panic attacks, pharmacotherapy is usually not indicated
