ISSN: 2041-6792

Clinical Investigation

Agoraphobia Open Access Scientific Journals

 Agoraphobia literally means “fear of the marketplace,” based on agora, the word for the Greek marketplace (Durand & Barlow, 2003). The term “agoraphobia” was first introduced by Westphal in 1871 to describe the fear and avoidance of public places, although this condition was not widely recognized until the late 1970s (Barlow, 2002).Diagnosis of Agoraphobia first appeared in the Diagnostic and Statistical Manual of Mental Disorders in its third edition (DSM-III; American Psychiatric Association [APA],1980). Agoraphobia was then considered a primary diagnosis, which may or may not be accompanied by recurrent panic attacks (Mennin, Heimberg, & Holt, 2000).However, since publication of the DSM-III-R (APA, 1987), a diagnosis of Panic Disorder is considered primary and is diagnosed either with or without Agoraphobia. Under the current DSM-IV (APA, 1994) diagnostic system, individuals exhibiting symptoms of Agoraphobia but never meeting full diagnostic criteria for Panic Disorder are given a diagnosis of Agoraphobia Without History of Panic Disorder(AWHPD). The DSM-IV (APA, 1994) describes Agoraphobia as anxiety about several different places or situations from which escape would be either difficult or embarrassing if some sort of unexpected or unwanted bodily symptoms occurred(Criterion A). As a result, such situations are either avoided, require the presence of a trusted person, or are endured with great distress (Criterion B). This anxiety and situational avoidance is not better explained by another anxiety disorder, such as Social Phobia or Specific Phobia (Criterion C). Although panic attacks or “panic-like” bodily sensations are often feared, other feared symptoms include loss of blade-der or bowel control, vomiting, or severe headache. Agoraphobia is not recognized by DSM-IV as a diagnosis on its own. An individual meeting criteria for Agoraphobia is then diagnosed with either Panic Disorder With Agoraphobia(PDA) (if diagnostic criteria for Panic Disorder are also met) or AWHPD. Both diagnoses require that the symptoms cannot be fully explained by a general med-ical condition and do not reflect the direct physiological effects of a substance.

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