Overview

• Soical Phobia → fear of social situations (eg. public speaking and small group events BUT can tolerate anonymous crowds unlike agoraphobia). Leads to avoidance of social situations. Must be present for at least 6 months.
  • Ix → Mini-SPIN questionnaire.
  • Management:
    • First Line → Individual CBT with ERP (Exposure Response Prevention).
    • Pharmacological (added on to CBT if poor response) → SSRI.
• Specific Phobia → phobia of specific situations, can invoke panic when exposed and cause physical symptoms.
  • Management:
    • Education, reassurance and self-help.
    • CBT (Individual) with ERP.
    • Relaxation therapy and breathing techniques.
• Agoraphobia → fear of being unable to escape to a safe place (ie. overwhelming desire to return home to safety). Eg. public transportation, being in crowds, being outside the home alone.
  • 40% risk of concurrent depressive disorder.
  • Presentation:
    • Anxiety may come on gradually or they may have panic attacks.
    • Avoidance of phobic situations + isolation behaviour.
  • Management:
    • First Line → psychoeducation, reassurance and guided self-help.
    • Second Line → CBT with ERP.

Key Diff: agoraphobia it is a fear of being unable to escape to a place of safety, e.g. from a crowd, public place, or somewhere far from home; for social phobia it is the fear of embarrassment, criticism, or scrutiny in social situations.

Making Diagnosis

Clinical Features

Investigations

Management Plan

Complications →

Prognosis →