Agoraphobia F40.0 - ICD10 Description, World Health Organization
Agoraphobia - Diagnostic Criteria, American Psychiatric AssociationApproximately 3.2 million , or about 2.2%, of adults in the US between the ages of 18 and 54, suffer from agoraphobia.
Effective therapiesThere is very little research on the treatment of agoraphobia without panic disorder. Research on the treatment of agoraphobia with panic disorder has found that cognitive behavioral therapy (CBT) [given by a therapist or by a computer], SSRI antidepressants, and clonazepam (an antianxiety medication) are all equally effective.
Ineffective therapiesResearch has shown tricyclic antidepressants (like imipramine) and Eye Movement Desensitization and Reprocessing (EMDR) are ineffective in the treatment of agoraphobia. Vitamins and dietary supplements are also ineffective for this disorder.
ComplicationsFear and its avoidance are the core features of all anxiety disorders. Agoraphobia can be thought of as "generalized phobic disorder" in which individuals develop many phobias that cause significant distress or disability. More than one-third of individuals with agoraphobia are homebound and unable to work; thus they are dependent on others to provide for their basic needs.
ComorbidityAs in panic disorder, many individuals with agoraphobia also develop major depressive disorder. Often these individuals may inappropriately self-medicate their anxiety with alcohol or sedatives, and thus may develop addiction as a consequence. Commonly, these individuals also suffer from other anxiety disorders (e.g., specific phobias, panic disorder, social anxiety disorder) and post-traumatic stress disorder.
Associated Laboratory FindingsNo laboratory test has been found to be diagnostic of this disorder.
PrevalenceThe 1-year prevalence rate in adolescents and adults is 1.7%, but this drops to 0.4% after age 65. Agoraphobia is rare in childhood, but its incidence peaks in late adolescence and early adulthood. Women are twice as likely as men to develop agoraphobia.
CourseAgoraphobia and panic disorder are closely associated. The majority of individuals with panic disorder have signs of agoraphobia before the onset of panic disorder. Likewise, 30% or more of individuals with agoraphobia have panic disorder before the onset of their agoraphobia. Onset of agoraphobia is before age 35 in two-thirds of individuals. The mean age of onset is 17 years. The course of agoraphobia is chronic and persistent. Complete recovery is rare (10%), unless treated.
Familial PatternTwin studies indicate a strong genetic contribution to the development of agoraphobia; its heritability is 61%.
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