Psychiatry - Neurosis/Agoraphobia

Question 1

Agoraphobia?

Answer 1

• Anxiety and panic symptoms associated with places or situations where escape may be difficult or embarrassing e.g. of crowds, public places, travelling alone or away from home, leading to avoidance
• Bimodal distribution; 15–35yrs, later life may develop 2° to physical frailty

Aetiology:

• Genetic and environmental factors:
• First-degree relatives also have an increased prevalence of other anxiety and
• related disorders (e.g. panic disorder, social phobia), alcohol misuse, and depressive disorders

Comorbidity:

• Panic disorder, depressive disorder, other anxiety and related disorders (e.g. 55% also have social phobia), alcohol and substance misuse

Question 2

Agoraphobia?

Differentials & Management?

Answer 2

Differentials:

• Other anxiety and related disorders (esp. generalized anxiety disorder, social phobia, OCD), depressive disorders,
• secondary avoidance due to delusional ideas in psychotic disorders

Management:

• Pharmacological: ADx as for panic disorder. BDZs short-term use only
• Psychological: Exposure techniques. relaxation training, and anxiety management. Cognitive methods