Agoraphobia is a persistent fear of being trapped in situations or places without a way to escape easily and without help. Diagnosis is by clinical criteria. Treatment is mainly with behavioral therapy.
(See also Agoraphobia in adults.)
Agoraphobia is uncommon among children, but it may develop in adolescents, particularly those who also have panic attacks. During a typical agoraphobic situation (eg, standing in line, sitting in the middle of a long row in a classroom), some people have panic attacks; others simply feel uncomfortable.
Agoraphobia often interferes with function and, if severe enough, can cause people to become housebound.
Diagnosis
Psychiatric assessment
Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) criteria
For agoraphobia to be diagnosed, patients must consistently have unreasonable fear or anxiety about ≥ 2 of the following for ≥ 6 months:
Using public transportation
Being in open spaces
Being in enclosed spaces
Standing in line or being in a crowd
Being outside the home alone
Also, the fear must cause patients to avoid the distressing situation to the extent that they have difficulty functioning normally (eg, going to school, visiting the mall, doing other typical activities).
Agoraphobia must be distinguished from the following:
Specific phobias (eg, to a certain situation)
Depression, which can cause patients to avoid leaving the house for reasons unrelated to anxiety
Treatment
Behavioral therapy
Behavioral therapy is especially useful for agoraphobia symptoms. Medications are rarely useful except to control any associated panic attacks.
