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Relating aspects of panic disorder and agoraphobia

Taylor Barr

In recent years, panic disorder (PD) has been recognized as a chronic illness with little spontaneous improvement in patients and a non-uniform course of illness. Agoraphobia (AG) is an anxiety symptom, to be in a place or situation where it is difficult (or embarrassing) to escape, or where there is no help in the event of an unexpected or situational panic attack (PA) or panic symptoms. Agoraphobia fear usually involves a set of unique situations, including being alone outside the house, being in the crowd or lined up; being on a bridge, travel by bus, train or car. There seems to be a clear link between panic attacks and the onset of agoraphobia. This concept is supported by current biological and psychological models of PD and AG. Early predictors of the onset of AG are important in clinical practice because coexisting AG leads to poor outcome and/or severe PD. The earliest possible predictor of the onset of AG in PD patients is characteristic of the First Panic Attack (FPA). One of the key characteristics of a patient's FPA is the location or situation in which the person experienced the FPA.


 
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