Phobic disorders

Question 1

Definition

Answer 1

In phobic states the anxiety is related to specific situations or objects.

Pts avoid these situations and become anxious when they anticipate having to meet them.

The three main types:

• simple phobias
• agoraphobia
• social phobias

The 10 most common phobias (in order) are:

1. spiders
2. people and social situations
3. flying
4. open space
5. confined spaces
6. heights
7. cancer
8. thunderstorms
9. death
10. heart disease.

Question 2

Management

Answer 2

The basis of treatment for all phobic disorders is psychotherapy that involves behaviour therapy and cognitive therapy.

Pharmacological treatment

• should be used only if non-pharmacological measures fail
  1. Agoraphobia with panic: use medications as for panic attacks
  2. Social phobia with performance anxiety: propranolol 10–40 mg (o) 30–60 mins before the social event or performance.
• Otherwise use an SSRI for problematic social phobia.
• Benzodiazipenes are not recommended.