Clinical features of the combination of agoraphobia and non-psychotic mental disorders

Abstract

The review article gives a modern definition of the concept of agoraphobia. Different classification approaches in the typing of agoraphobia are presented. Its role as a factor aggravating the course of non-psychotic mental disorders is shown. The features of its manifestation depending on the nosological affiliation are analyzed. It was revealed that agoraphobia is a predictor of an unfavorable outcome in people with panic disorder. In turn, panic disorder often causes the development of agoraphobia. At the same time, gender and age aspects are noted. The comorbidity of agoraphobia and somato-vegetative type of generalized anxiety disorder is shown. Agoraphobia increases the risk of suicidal behavior in depression, has a high correlation with the severity of personality disorders, especially of the avoidant and dependent type. At the same time, some researchers dispute the point of view that these types of personality disorders are predisposing factors for panic disorder and agoraphobia, based on retrospective data on the premorbid personality structure of patients with anxiety disorders. The relationship between PTSD and panic disorder is emphasized in connection with the emergence of a circular model of the development of feelings of fear, which postulates a similar etiology of anxiety disorders. There is a comorbidity of agoraphobia with disorders of the hypochondriac spectrum: from the degree of fixation to obsessive nature. reduces the effectiveness of therapy for schizophrenic spectrum disorders and the quality of life of patients. The picture of the panic disorder itself with agoraphobia becomes heavier if the patient has chronic alcoholism (in particular, the frequency of seizures increases), while the presence of agoraphobic symptoms leads to a relapse of alcoholic illness, which is explained by taking alcohol to relieve symptoms, and also increases the likelihood of developing dependence on tranquilizers.