Phobias Disease
DESCRIPTION
A persistent irrational fear of a specific object, activity or situation that results in a compelling desire to avoid the perceived fear. Psychiatric conditions classified in Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-R) as anxiety disorders. When confronted with the phobic stimulus, patient reacts with intense anxiety, usually realizes the fear is excessive or exaggerated. When a fear causes significant distress and interferes with normal functions of life, then it is considered a psychiatric disorder.
- Agoraphobia: Fear of being trapped in a situation where escape is impossible or difficult. Fear centers on (1) fear of being alone, (2) fear of being away from home and (3) fear of being in a place from where escape is difficult - seen most often in association with panic disorder.
- Simple phobia: Fear of a discrete stimulus such as animals, insects, heights, flying, closed spaces (claustrophobia), blood-injury phobia
- Social phobia: Fear of humiliation or embarrassment in social situations where person may be under scrutiny by others, e.g., performance anxiety, speaking in public, or fear of using public toilets
- System(s) affected: Nervous
- Genetics: No consistent genetic pattern
- Incidence/Prevalence in USA: 1 month prevalence of all phobic conditions: 6.2%; lifetime prevalence: 12.5%
- Predominant age:
- Agoraphobia - onset 18-35 (mean 24)
- Simple phobia fear of animals - onset usually in childhood (mean 4.4 years)
- Simple phobia fear of heights, claustrophobia - 4th decade
- Other simple phobias - mean 22.7 years
- Social phobia - late childhood, adolescence (mean 19 years)
- Predominant sex:
- Female > Male, overall phobias
- Male = Female, social phobia
SIGNS AND SYMPTOMS
- Extreme anxiety when exposed to phobic stimulus
- Tremors
- Palpitations
- Sweating
- Blushing
- Dyspnea
- Dizziness
- Associated nausea
CAUSES
- Persistence or exaggeration of learned response, learned initially as a protective mechanism (such as avoidance of large dogs by small children)
- Social - learned maladaptive anxiety response to social situation
RISK FACTORS
- For all phobias - presence of another psychiatric disorder
- Separation anxiety in childhood
- Introverted or dependent personality
LABORATORY
None
Drugs that may alter lab results: N/A
Disorders that may alter lab results: N/A
PATHOLOGICAL FINDINGS
N/A
SPECIAL TESTS
None
IMAGING
N/A
DIAGNOSTIC PROCEDURES
- Careful history and observation of the patient
- Description of the behavior by patient, family or friends
- Psychiatric examination
APPROPRIATE HEALTH CARE
Outpatient
GENERAL MEASURES
- Agoraphobia:
- Behavioral treatment
- Graduated exposure
- Different treatment required when agoraphobia is associated with panic disorder
- Simple phobia:
- In vivo or graduated exposure
- Fear of flying specifically - benzodiazepine
- Social phobia:
- Social skills training
- Graduated exposure
- Performance anxiety or situations where patient in a circumscribed setting - beta blocker
SURGICAL MEASURES
N/A
ACTIVITY
No restriction
DIET
Consider restriction of stimulants - such as caffeine, nicotine, xanthines, sympathomimetics, which can overdrive anxiety. Phenelzine - requires tyramine free diet.
PATIENT EDUCATION
- Cognitive therapy
- Phobia clinic or group therapy, if available
- Anxiety Disorders of America
PREVENTION/AVOIDANCE
N/A
POSSIBLE COMPLICATIONS
- Avoidance behavior
- Episodic alcohol, barbiturate and anxiolytic abuse/overuse and dependence as patients try to self-medicate to ameliorate symptoms
- Development of mild depression
EXPECTED COURSE AND PROGNOSIS
- Agoraphobia - usually associated with panic disorder, chronic. Often patient becomes more and more home-bound as condition continues.
- Simple phobia - some spontaneously remit as person ages (as in some simple phobias of childhood), alternatively some become chronic. Impairment can be minimal if object can be avoided (such as snakes). Although improvement occurs with in vivo exposure, phobia can recur after successful treatment.
- Social phobia - chronic course
ASSOCIATED CONDITIONS
- For all phobias - depression, substance abuse
- Social and agoraphobia - panic attacks or panic disorder
AGE-RELATED FACTORS
Pediatric: Animal phobia mean age of onset 4.4 years
Geriatric:N/A
Others: N/A
PREGNANCY
No data
OTHER NOTES
N/A
ABBREVIATIONS
PTSD = posttraumatic stress disorder
Clinical Investigations
- Cardiology
- Dermatology
- General Destistry
- Cardiology
- Dermatology
ROLE OF HOMOEOPATHY
Holistic healing that treats the person, not just the disease. Experience gentle, lasting wellness with expert constitutional care.
Copyright © 2025 Selkey. All Rights Reserved.