Phobia

Question 1

Define phobias.

Answer 1

Anxiety disorders including agoraphobia (fear of public places), social phobia (fear of people and being judged) and specific phobias (persistent fear of specific object or situaiton).

Question 2

Explain the aetiology/risk factors of phobias.

Answer 2

Genetic factors relevant. Behavioral copying learned from parents (especially specific phobias)

Agoraphobia often follows traumatic event. Strong association with panic and ICD-10 classification includes with/without panic disorder

Question 3

Summarise the epidemiology of phobias.

Answer 3

F>M onset early twenties or late adolescence

Question 4

What are the signs and symptoms of phobias?

Answer 4

Agoraphobia: Marked fear of crowds, public places, travelling alone, being away from home. Somatic anxiety symptoms may occur in anticipation of it. Avoidance of these situations alone is prominent feature, may be able to stand them if with someone else.

Social phobia: Situaitonal anxiety in social groups: parties, meetings, classroms. There is marked avoidance, anxiety symptoms and blushing, fear of vomiting and urgency/fear of micruition.

Specific phobia: Recognised as irrational but can not go away. Anxiety and panic when exposed to object. Most common phobias include animals, blood or injury, heights, illness. Somatic anxiety symptoms occur on exposure.

Question 5

What investigations can be performed for phobias?

Answer 5

FBCs

U+Es

Ca2+

LFTs

TFTs

Question 6

What is the management for phobias?

Answer 6

Exposure therapy

Gradual increase

CBT

SSRI/BZD to aid with gradual re-exposure

Question 7

What are the complications associated with phobias? What is the prognosis of phobias?

Answer 7

Agoraphobia: Isolation and secondary depression.

Social: May be secondary to depressive illness when social preformance declines. Secondary drug abuse common in older age groups.

Specific: Disruption of normal daily life if stimulus present in it.