Agoraphobia

Agoraphobia is characterized by out of proportional fear of a situation, which can lead to avoidance of the situation as well as development of panic attacks.

Feared situations may include open spaces, crowds, or being alone and far from home. This can result in significant impairment of psychosocial and physical functioning.

Agoraphobia may also be associated with panic attacks, as well as other comorbid anxiety or mood disorders.

Agoraphobia may develop due to a combination of genetic and environmental factors on fear processing and how a person responds to triggers.

Assessment

This would involve a thorough history and mental state examination, to understand the nature of the anxiety and the associated triggers. The evaluation would also include the impact of the person’s functioning. It is also important to rule out any physical health conditions which may appear to present like agoraphobia.

Management

The first line management of agoraphobia involves a psychotherapeutic approach. This may involve a Cognitive Behaviour Therapy (CBT).

Patients may also require the use of antidepressants such as SSRIs, SNRIs, TCAs. If symptoms are severe, the patient may require short term use of benzodiazepines.

All cases require careful monitoring of treatment and drug titration according to response. Earlier treatment appears to have better prognosis than advanced conditions.

Guirish Radja