The essential feature of Agoraphobia is anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having a Panic Attack or panic-like symptoms.
Agoraphobic fears typically involve characteristic clusters of situations that include being outside the home alone; being in a crowd or standing in a line; being on a bridge; and traveling in a bus, train, or automobile.
A person who experiences agoraphobia avoids such situations (e.g., travel is restricted) or else they endure with significant distress or with anxiety about having a Panic Attack or panic-like symptoms. People with agoraphobia often require the presence of a companion.
Anxiety or phobic avoidance in agoraphobia can not be better accounted for by another mental disorder, such as Social Phobia (e.g., avoidance limited to social situations because of fear of embarrassment), Specific Phobia (e.g., avoidance limited to a single situation like elevators), Obsessive-Compulsive Disorder (e.g., avoidance of dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., avoidance of stimuli associated with a severe stressor), or Separation Anxiety Disorder (e.g., avoidance of leaving home or relatives).
Agoraphobia is generally not diagnosed if Panic Disorder has already been previously diagnosed. As with all mental disorders, the symptoms listed above are not due to the direct physiological effects of a use or abuse of a substance (e.g., alcohol, drugs, medications) or a general medical condition.
References:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
National Institutes of Health, National Institute of Mental Health, NIH Publication No. 95-3879 (1995)
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