A 36-year-old man presented to the outpatient with long standing history of fainting and blurred vision when travelling on bus. The symptoms are less when he travel by his wife’s car. He avoids public transpo and is confined to home. At present his wife works and cooks for him. He does not leave home to shop or for enteainment. He describes to you that he has had some bad experiences of felling like his hea is racing, sweating and intense fear when he was at work. What is the most likely diagnosis?

Correct Answer: Agoraphobia
Description: In agoraphobia there is fear of being in places where escape is impossible. Travelling away from home will worsen anxiety symptoms. Travelling by bus, train or flight can be difficult because it cannot be easily stopped or returned. Familiar vehicles like private cars are much easier for patients. It is the most disabling of anxiety diorders because it affects the social functioning. It is often associated with Panic Disorder. Symptoms of anxiety include, intense fear, palpitations, sweating, shakiness, diziness, blurred vision and fainting. Ref: Kaplan & Sadock's Synopsis of Psychiatry, By Benjamin J Sadock, M.D., Harold I. Kaplan, Virginia A Sadock, M.D, 10th Edition, Page : 265
Category: Psychiatry
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