Agoraphobia

Dr-Elze.de Dr. Elze

Agoraphobia is known to be associated with a pronounced fear of public places, traveling and / or of leaving the house. The term agoraphobia is derived from the Greek words agora = market (-place) and phobos = fear.

The term agoraphobia was formed in 1872 by the German neurologist Carl Westphal. Westphal described an disorder, in which patients “were not possible to walk over certain streets and places, and [the] fear of such paths limited them in the freedom of their movements”.

Most patients with agoraphobia suffer not only from “fear of places”. In most cases various public situations such as crowds, department stores, supermarkets, public transportation such as bus or subway, cinema, theater and restaurant visits and the like may cause symptoms of anxiety or panic. Therefore, the term agoraphobia is used today to generally describe fear of public places, of traveling and / or of leaving the house.

In addition, most patients with agoraphobia suffer from panic disorder, a disorder with severe anxiety attacks that go along with various physical symptoms such as palpitations, dizziness, shortness of breath.

Carl Westphal

The term agoraphobia, derived from the Greek αγορά (agora) “market, marketplace” and φόβος (phobos) “fear”, was introduced in 1872 by the German psychiatrist Carl Westphal.

Westphal wrote that the agoraphobia is a “neuropathic phenomenon” in which a patient “was unable to walk over squares and through certain streets and was, out of fear of such paths, restricted in the freedom of movement” (cf. Westphal 1872).

To his chose of the term “agoraphobia” Westphal added: “This fear of walking over squares or through streets presented the main phenomenon, so that I, even though there were fears referring to some other situations, and therefore the chosen name is not exhaustive, felt being able to construct the word agoraphobia, fear of squares.” (cf. Westphal 1872).

(Click here for the original text in German.)

Sigmund Freud and Josef Breuer

In the first decades of the 20th century, anxiety disorders such as agoraphobia and panic disorder were - according to the works of Sigmund Freud and Josef Breuer - termed as anxiety neurosis (anxiety without situational trigger) and anxiety hysteria (anxiety with situational triggers) (cf. Breuer / Freud 1895).

ICD-10 / DSM-5

The terms “agoraphobia” and “panic disorder” found as late as 1980, over one hundred years after the descriptions of Carl Westphal, with the publication of the DSM-III their way into the medical classification systems. The inclusion in the International Classification of Diseases (ICD) took place with the publication of the 10th edition. While the diagnostic criteria for agoraphobia and panic disorder in ICD-10 and DSM-IV are now largely similar, as a result of different aetiological models there are still divergent classifications in DSM-IV, DSM-5 and ICD-10 .

Dr. Sandra Elze & Dr. Michael Elze