(See also Agoraphobia Agoraphobia Agoraphobia is intense anxiety and/or avoidance of situations (eg, being in crowds or shopping malls, driving) that may be difficult to leave or in which help is not readily available if incapacitating... read more 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 Panic Disorder in Children and Adolescents Panic disorder is characterized by recurrent, frequent (at least once/week) panic attacks. Panic attacks are discrete spells lasting about 20 minutes; during attacks, children experience somatic... read more ; 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 Depressive Disorders in Children and Adolescents Depressive disorders are characterized by sadness or irritability that is severe or persistent enough to interfere with functioning or cause considerable distress. Diagnosis is by clinical criteria... read more , 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.
