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Zhurnal Nevrologii I Psikhiatrii Imeni... 1999There were studied 2 groups of the patients with a diagnosis of agoraphobia (according to ICD = 10). The first group included 34 patients which didn't use a specialized... (Comparative Study)
Comparative Study Review
There were studied 2 groups of the patients with a diagnosis of agoraphobia (according to ICD = 10). The first group included 34 patients which didn't use a specialized psychiatric service; the second one included 25 patients which needed an active therapy under conditions of psychiatric hospital. Dynamics of a disease was investigated by the method of retrospective (3 years) and following prospective (3 years) evaluation. The first group was characterized by relatively favourable outcome of chronic anxious-phobic disorders (APD) with the phenomena of a stable agoraphobia (5.8% of patients with a decrease of social adaptation): a limited agoraphobic avoidance (2 cases in the average), a rare and only psychogenic exacerbation (23 cases). Comorbid disorders were presented as minor depression (53%), somatophormic disorders (single isolated cardialgias and the conversive disorders--28%), personal disorders of hyperthimic (53%) and hysteric (35.5%) type. The second group was characterised by relatively worse outcome of chronic APD with the phenomena of a stable agoraphobia (32.0% of the patients with a decrease of social adaptation), that was associated with more generalized avoidance behaviour (more than 2 cases), with a gradual increase of both the severity of panic attacks and agoraphobia in limits of either periodic long-term aggravations (46%) or a continuous progredient course (29%). As compared with the 1-st group the second group was also characterised by significantly higher average number in a month of the panic attacks (4.9 + 1.1 vs 2.4 + 0.4; p < 0.01) and hospitalization (2.5 + 0.6 vs 0.2 + 0.2 + 0.1; p < 0.05) during all period of prospective observation. More severe comorbid disorders were revealed: slow-progredient schizophrenia (20% vs 0% in the first group; p < 0.01), a major depressive disorder (28% vs 3%; p < 0.01), dysthymic disorder (32% vs 3%; p < 0.05); personal disorders were presented mostly by the deviations of schizoid type (59%).
Topics: Adaptation, Psychological; Adult; Agoraphobia; Anxiety; Chronic Disease; Female; Follow-Up Studies; Hospitalization; Hospitals, Psychiatric; Humans; Male; Phobic Disorders; Severity of Illness Index; Social Adjustment; Time Factors
PubMed: 10533247
DOI: No ID Found -
International Clinical... Aug 2000This review article summarizes comparator-controlled, short-term studies with currently available selective serotonin reuptake inhibitors (SSRIs) in the treatment of... (Review)
Review
This review article summarizes comparator-controlled, short-term studies with currently available selective serotonin reuptake inhibitors (SSRIs) in the treatment of panic disorder and agoraphobia. Fluvoxamine, fluoxetine, paroxetine, sertraline and citalopram have all been proven to be superior to pill-placebo in the treatment of panic disorder, agoraphobia and associated symptoms such as depression. Direct comparisons with other antidepressants, benzodiazepines, cognitive-behavioural therapies or combinations of SSRIs with psychotherapeutic interventions are scarce. The majority of studies have reported on fluvoxamine whereas, to date, sertraline and citalopram have been compared only with placebo. Meta-analyses have suggested that combining an antidepressant with exposure in vivo produces the greatest treatment gains. Since this procedure is already commonly used in everyday clinical practice, it is recommended that future research in the treatment of panic disorder be directed towards the investigation of a combination of SSRIs with exposure therapy.
Topics: Agoraphobia; Combined Modality Therapy; Humans; Panic Disorder; Selective Serotonin Reuptake Inhibitors
PubMed: 11110016
DOI: 10.1097/00004850-200008002-00005 -
Yonsei Medical Journal Nov 2023This study aimed to compare the clinical features of panic disorder (PD) with comorbid agoraphobia to those of PD alone. We focused on autonomic nervous system (ANS)...
PURPOSE
This study aimed to compare the clinical features of panic disorder (PD) with comorbid agoraphobia to those of PD alone. We focused on autonomic nervous system (ANS) alterations reflected in heart rate variability (HRV) and executive function deficits reflected in the Stroop test.
MATERIALS AND METHODS
We retrospectively compared psychometric features, Stroop test results, and resting-state HRV across three groups: a subclinical group with anxiety attack history, a PD group without agoraphobia, and a PD group with agoraphobia. The subclinical group included 10 male and 34 female, the PD without agoraphobia group included 17 male and 19 female, and the PD with agoraphobia group included 11 male and 18 female.
RESULTS
The PD with agoraphobia group had higher Symptom Checklist-95 scores than the other groups. Both PD groups had longer reaction times in the Stroop test than the subclinical group. There were no significant differences in HRV parameters between the PD groups with and without agoraphobia. Compared with the subclinical group, the PD with agoraphobia group showed significantly lower values of the natural logarithm of low-frequency HRV.
CONCLUSION
Our results do not support that executive function deficits and ANS alterations are more pronounced with comorbid agoraphobia among PD groups. However, PD with agoraphobia patients showed more complex and severe clinical symptoms in their self-reports. Compared with the subclinical group, PD patients with agoraphobia showed specific features in the natural logarithm of low-frequency HRV. Our findings suggest that agoraphobia comorbidity should be considered when evaluating or treating patients with PD.
Topics: Humans; Male; Female; Panic Disorder; Agoraphobia; Retrospective Studies; Heart Rate; Anxiety
PubMed: 37880848
DOI: 10.3349/ymj.2022.0592 -
Journal of Affective Disorders Mar 2015We investigated the efficacy of an intensive 1-week behavioral therapy program focusing on agoraphobia for panic disorder patients with agoraphobia (PDA).
BACKGROUND
We investigated the efficacy of an intensive 1-week behavioral therapy program focusing on agoraphobia for panic disorder patients with agoraphobia (PDA).
DESIGN AND METHODS
The study design was a case-control study. Main outcome measure was the agoraphobia score of the Fear Questionnaire (FQ-AGO). The outcomes on the FQ-AGO of a 1-week intensive therapy (96 patients) and a twice-weekly therapy (98 patients) were compared.
RESULTS
Agoraphobia improved significantly in both groups, 1 week and 3 months after therapy. Effect size for changes in the 1-week intensive therapy on the FQ-AGO was 0.75.
LIMITATIONS
Limitations are use of antidepressants, no placebo group, and no long term follow-up.
CONCLUSION
Behavioral therapy for agoraphobia can be shortened significantly if intensified without affecting therapy outcome, thus allowing patients a more rapid return to work and resumption of daily activities.
Topics: Adult; Agoraphobia; Antidepressive Agents; Behavior Therapy; Case-Control Studies; Cognitive Behavioral Therapy; Comorbidity; Desensitization, Psychologic; Fear; Female; Humans; Male; Middle Aged; Panic Disorder; Psychometrics; Surveys and Questionnaires; Time Factors; Treatment Outcome
PubMed: 25479049
DOI: 10.1016/j.jad.2014.11.029 -
The American Journal of Psychiatry Jul 2013The purpose of this study was to estimate the general population incidence of late-life agoraphobia and to define its clinical characteristics and risk factors.
OBJECTIVE
The purpose of this study was to estimate the general population incidence of late-life agoraphobia and to define its clinical characteristics and risk factors.
METHOD
A total of 1,968 persons ≥65 years old were randomly recruited from the electoral rolls of the district of Montpellier, France. Prevalent and incident agoraphobia diagnosed with a standardized psychiatric examination and validated by a clinical panel were assessed at baseline and over a 4-year follow-up.
RESULTS
The 1-month baseline prevalence of agoraphobia was estimated to be 10.4%. Among persons with agoraphobia, 10.9% reported having their first episode at age 65 or above. During the 4-year follow-up, 11.2% of participants without agoraphobia at baseline had a first episode, resulting in an incidence rate of 32 per 1,000 person-years. These 132 incident late-onset cases were associated with higher incidence rates of anxiety disorders and suicidal ideation. Of the incident cases, only two were characterized by past or concurrent panic attacks, a rate that was not significantly different from that of the noncase group. The principal baseline risk factors for incident cases, derived from a multivariate model incorporating all significant risk factors, were younger age at onset (odds ratio=0.94, 95% CI=0.90-0.99), poorer visuospatial memory performance (odds ratio=1.60, 95% CI=1.02-2.49), severe depression (odds ratio=2.62, 95% CI=1.34-5.10), and trait anxiety (odds ratio=1.73, 95% CI=1.03-2.90). No significant association was found with cardiac pathologies.
CONCLUSIONS
Agoraphobia has a high prevalence in the elderly, and unlike cases in younger populations, late-onset cases are not more common in women and are not associated with panic attacks, suggesting a late-life subtype. Severe depression, trait anxiety, and poor visuospatial memory are the principal risk factors for late-onset agoraphobia.
Topics: Age Factors; Age of Onset; Aged; Aged, 80 and over; Agoraphobia; Female; France; Humans; Incidence; Interview, Psychological; Male; Panic Disorder; Prevalence; Risk Factors
PubMed: 23820832
DOI: 10.1176/appi.ajp.2013.12091235 -
American Journal of Psychotherapy Jul 1985Findings from empirical research and clinical practice are comprehensively integrated into a topography of the agoraphobic syndrome. The following topics are discussed...
Findings from empirical research and clinical practice are comprehensively integrated into a topography of the agoraphobic syndrome. The following topics are discussed successively: the agoraphobic syndrome (core mechanism and life pattern), the pathogenesis (causal mechanism, antecedents, and predispositions), the different kinds of anxiety from which agoraphobes can suffer, and the broad-spectrum therapeutic implications.
Topics: Adult; Agoraphobia; Anxiety Disorders; Avoidance Learning; Female; Humans; Life Style; Male; Phobic Disorders; Risk; Set, Psychology; Social Environment
PubMed: 4051056
DOI: 10.1176/appi.psychotherapy.1985.39.3.371 -
Psychological Medicine Mar 2023Agoraphobic avoidance of everyday situations is a common feature in many mental health disorders. Avoidance can be due to a variety of fears, including concerns about...
BACKGROUND
Agoraphobic avoidance of everyday situations is a common feature in many mental health disorders. Avoidance can be due to a variety of fears, including concerns about negative social evaluation, panicking, and harm from others. The result is inactivity and isolation. Behavioural avoidance tasks (BATs) provide an objective assessment of avoidance and anxiety but are challenging to administer and lack standardisation. Our aim was to draw on the principles of BATs to develop a self-report measure of agoraphobia symptoms.
METHOD
The scale was developed with 194 patients with agoraphobia in the context of psychosis, 427 individuals in the general population with high levels of agoraphobia, and 1094 individuals with low levels of agoraphobia. Factor analysis, item response theory, and receiver operating characteristic analyses were used. Validity was assessed against a BAT, actigraphy data, and an existing agoraphobia measure. Test-retest reliability was assessed with 264 participants.
RESULTS
An eight-item questionnaire with avoidance and distress response scales was developed. The avoidance and distress scales each had an excellent model fit and reliably assessed agoraphobic symptoms across the severity spectrum. All items were highly discriminative (avoidance: = 1.24-5.43; distress: = 1.60-5.48), indicating that small increases in agoraphobic symptoms led to a high probability of item endorsement. The scale demonstrated good internal reliability, test-retest reliability, and validity.
CONCLUSIONS
The Oxford Agoraphobic Avoidance Scale has excellent psychometric properties. Clinical cut-offs and score ranges are provided. This precise assessment tool may help focus attention on the clinically important problem of agoraphobic avoidance.
Topics: Humans; Reproducibility of Results; Agoraphobia; Anxiety; Anxiety Disorders; Fear; Panic Disorder
PubMed: 37010211
DOI: 10.1017/S0033291721002713 -
Behaviour Research and Therapy 1990This article presents the Agoraphobia Scale (AS), and evidence for its reliability, validity, and sensitivity to change after treatment. The scale consists of 20 items...
This article presents the Agoraphobia Scale (AS), and evidence for its reliability, validity, and sensitivity to change after treatment. The scale consists of 20 items depicting various typical agoraphobic situations, which are rated for anxiety/discomfort (0-4) and avoidance (0-2). The results show that AS has high internal consistency. Regarding concurrent validity it correlated significantly with other self-reported measures of agoraphobia (Mobility Inventory and Fear Questionnaire). The scale's predictive validity was shown as it correlated with avoidance behavior and self-rated anxiety during both an individualized and a standardized behavioral test of agoraphobia. The AS also discriminated between an agoraphobic sample and a normal sample, and a sample of simple phobia patients. Finally, it was sensitive to changes after behavioral treatment. The AS is useful both as a state, and as an outcome self-report measure of agoraphobia.
Topics: Adult; Agoraphobia; Arousal; Female; Humans; Male; Personality Tests; Psychometrics
PubMed: 2222389
DOI: 10.1016/0005-7967(90)90084-v -
American Journal of Psychotherapy Jul 1978For effective treatment of agoraphobia both patient and therapist must understand the mechanisms of sensitization and self-desensitization. Rather than aiming to adapt...
For effective treatment of agoraphobia both patient and therapist must understand the mechanisms of sensitization and self-desensitization. Rather than aiming to adapt to difficult situations, to achieve desensitization by suggestions, or to avoid panic, the agoraphobe must learn to pass through panic and to rid oneself of drug dependency. This method of self-desensitization will, as a rule, achieve results quickly and does not necessarily depend upon finding the cause of the original sensitization.
Topics: Adaptation, Psychological; Adult; Agoraphobia; Desensitization, Psychologic; Female; Humans; Male; Mental Fatigue; Panic; Phobic Disorders; Repression-Sensitization; Stress, Psychological
PubMed: 29502
DOI: 10.1176/appi.psychotherapy.1978.32.3.357 -
American Journal of Psychotherapy Jan 1984A female patient with agoraphobia is presented to demonstrate the need for maximal flexibility in designing a treatment program for the agoraphobic patient. This patient...
A female patient with agoraphobia is presented to demonstrate the need for maximal flexibility in designing a treatment program for the agoraphobic patient. This patient required a multimodal approach utilizing pharmacotherapy, marital psychotherapy, and individual psychotherapy, alone and in combination. The paper looks specifically at nodal decision points in treatment at which reassessment was necessary and changes in psychotherapeutic intervention were made. The importance and implications of involving the patient's significant other in treatment are explored with respect to the outcomes such involvement may have on the treatment. A review of the literature on treatments for agoraphobia highlights the conclusion reached, that the agoraphobic patient presents with a biopsychosocial problem which frequently requires the clinician to combine several treatment modalities.
Topics: Adult; Agoraphobia; Combined Modality Therapy; Female; Humans; Imipramine; Marital Therapy; Panic; Phobic Disorders; Psychotherapy; Sex
PubMed: 6711708
DOI: 10.1176/appi.psychotherapy.1984.38.1.35