Comorbidity

When patients with a mental disorder consult a doctor, they describe their principal complaint, and while there may be other disorders present that complicate or are more important, the wise clinician will pay attention to the disorder that troubles the patient the most. Structured diagnostic interviews are impervious to the person's principal complaint and ask about each disorder in turn. Regier et al. 26 examined the two waves of the ECA data and concluded that anxiety disorders, especially...

Cognitive Approach to Phobias

Jean-Pierre Lepine and Catherine Musa1 Marks and Mataix-Cols describe the current problems in classifying phobias as well as the potential bases of their taxonomy. It is important to underline that Isaac Marks' work in this field has been of major historical significance. It permitted the distinction of phobias within the anxiety disorders and the distinction of different phobic syndromes according to their phenomenological components as well as their age of onset. However, this classification...

Purposes Of Diagnostic And Other Classifications

Classification is the arrangement of phenomena into classes with common features. Classes can be categories that are mutually exclusive, like most animal species, even though we cannot say exactly when the apes that preceded hominids became hominid on gradually evolving dimensions of change. Classes may overlap, like human physical types. Classes may shade into one another along continuous dimensions like age. We cannot say exactly when an infant becomes a toddler, a toddler a child, a child an...

Service Utilization

In the ECA surveys, Regier et al. 37 found that 59 of people with panic consulted a medical practitioner in the preceding year, a rate comparable to that of people with bipolar disorder or schizophrenia. On the other hand, only 31 of people with a phobia consulted, a rate virtually identical to that for all people with mental disorders. People with panic disorder alone made high use of hospital emergency departments, but people with agoraphobia with panic attacks were also high service users 38...

Phobias May be Cued Triggered Evoked by Almost Anything

A classification based entirely on the triggers of terror leads to an endless terminology telling us little beyond the label. Such a classification was prominent in the past. Numerous Greek and Latin prefixes were attached to -phobia according to the object or situation that was feared (for a long table of such phobias, see 13 ). Today's enquirers from the media often ask ''What do you call a phobia of spiders (or heights or blushing or whatever) '' and rest content with the label...

Phobias Reflections on Definitions

Khatcherian2 Although phobias are classified as part of anxiety disorders, what applies to anxiety disorders does not necessarily apply to phobias and what applies to a given phobia does not necessarily apply to another phobia. There are advantages in lumping them together, but they do differ in many aspects. Phobias as a group and anxiety disorders as a family do not have similar ''clinical significance'', comorbidity, age of onset and treatment outcome. The issue...

Specific Isolated Phobias F402 30029

The presenting complaint is a phobia focusing mainly on well-defined situations with relatively little phobia of anything else. Examples are certain animals or insects darkness, storms, heights, enclosed spaces, lifts water, noise flying or other specific forms of travel certain foods blood, injury, injection or other medical or dental procedures a particular illness triggers of anger that is hard to manage. Encountering or thinking about the feared object or situation may evoke striking...

The Main Phobic Syndromes

The rest of this chapter outlines each syndrome of anxious avoidance that has a phobia diagnosis in ICD-10 (F40) and DSM-IV-TR (300.2). Thereafter it notes more briefly other syndromes of anxious avoidance. Almost all the syndromes are detailed in Marks 19,41 . They are described in the order in which they appear in the left-hand column of Table 1.1. Table 1.1 Phobias coded under anxiety disorders in ICD-10 11 and DSM-IV-TR 8 F40-48 NEUROTIC, STRESS-RELATED AND SOMATOFORM DISORDERS F40 Phobic...

Dysmorphophobia F452 Body Dysmorphic Disorder 3007

Dysmorphophobic worry about how one looks or smells can cause handicap like that from social phobia. The phobia may be of being too short or too tall, too thin or too fat, being bald or having a big nose or bat ears or a protruding bottom, or being too flat-chested or too bosomy as a woman. Sufferers are endlessly preoccupied with minor or totally imagined body defects that are not evident even to the keenest observer. Severe dysmorphophobia can lead to avoidance of public transport or going on...

References

Kendler K.S., Neale M.C., Kessler R.C., Heath A.C., Eaves L.J. (1992) The genetic epidemiology of phobias in women the interrelationship of agoraphobia, social phobia, situational phobia, and simple phobia. Arch. Gen. Psychiatry, 49 273-281. 2. Kendler K.S., Jyers J., Prescott C.A., Neale M.C. (2001) The genetic epidemiology of irrational fears and phobias in men. Arch. Gen. Psychiatry, 58 257-265. 3. Stein M.B., Chartier M.J., Hazen A.L., Kozak M.V., Tancer M.E., Lander S., Furer P., Chubaty...

Social Phobia F401 30023

When the normal slight anxiety at social occasions becomes so great as to disrupt everyday life, then it is a social phobia. Social phobia may be very focal, or involve several situations (mostly separate from agoraphobic ones), or be diffuse. Social phobia largely concerns a fear of scrutiny, of what other people think. A glance from someone else precipitates panic about being thought stupid. Sufferers may fear eating and drinking in front of others their fear may be of their hands trembling...

Medical References For Social Phobia

Stengel E. (1959) Classification of mental disorders. WHO Bull., 21 601-663. 2. American Psychiatric Association (1952) Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association, Washington, DC. 3. American Psychiatric Association (1968) Diagnostic and Statistical Manual of Mental Disorders, 2nd edn. American Psychiatric Association, Washington, DC. 4. Marks I.M. (1969) Fears and Phobias. Heinemann, London. 5. Marks I.M. (1970) The classification of phobic...

Post Traumatic Stress Disorder F431 30981

When the normal reaction to severe trauma lasts longer than a month and is particularly severe, then it is called post-traumatic stress disorder. Sufferers feel tense, irritable, spaced out, startle easily, cannot sleep, and have nightmares and flashbacks about the trauma. Depression and a sense of numbing are frequent, as is grief from any loss associated with the trauma. Patients avoid places, people, thoughts and other reminders of what happened, and this often-prominent aspect of...