A middle aged person presented with the complaints of fear of leaving home, fear of travelling alone and fear of being in a crowd. He develops marked anxiety with palpitations and sweating, if he is in these situations. The most likely diagnosis is:
**Core Concept**
The patient's symptoms suggest a specific phobic disorder characterized by excessive and irrational fear of being in public places or crowded areas, leading to avoidance of such situations.
**Why the Correct Answer is Right**
The patient's symptoms are characteristic of Agoraphobia, a type of anxiety disorder. Agoraphobia is often associated with Panic Disorder, where individuals experience panic attacks in response to feared situations. The patient's fear of leaving home, travelling alone, and being in crowds, along with the physical symptoms of palpitations and sweating, are consistent with Agoraphobia. This condition often involves a fear of being in public places where escape might be difficult or embarrassing, or where help might not be available in the event of having a panic attack.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not accurately describe the patient's symptoms. While social anxiety disorder involves fear of social or performance situations, it does not typically involve fear of being in crowded areas or public places.
**Option B:** This option is incorrect because it is too broad. The patient's symptoms are specific to a fear of public places or crowded areas, not a general fear of being in any situation that might be embarrassing or humiliating.
**Option C:** This option is incorrect because it does not accurately describe the patient's symptoms. While specific phobias involve excessive and irrational fear of specific objects or situations, the patient's fear is more complex and involves a fear of being in public places or crowded areas.
**Clinical Pearl / High-Yield Fact**
A key feature of Agoraphobia is the avoidance of situations where escape might be difficult or embarrassing, or where help might not be available in the event of having a panic attack. This avoidance behavior is a hallmark of the disorder and is often used as a diagnostic criterion.
**Correct Answer:** C.