Summary
Definition
History and exam
Key diagnostic factors
- ansiedade antecipatória
- comportamento de evitação
Other diagnostic factors
- início na infância
- início na fase adulta jovem
- náuseas
- tontura
- nojo
- desmaios
- taquicardia
- hiperventilação
- resposta de sobressalto exagerada
- perturbações do sono
Risk factors
- transtorno de somatização
- transtornos de ansiedade
- transtornos de humor
- parente de primeiro grau com fobia
- gêmeos com fobia
- experiências aversivas
- estresse e eventos de vida negativos
- sexo feminino
- etnia branca
- ansiedade e superproteção parentais
- afetividade negativa e inibição comportamental
- viés cognitivo/de atenção
Diagnostic investigations
1st investigations to order
- autorrelato
- observação comportamental e testes de aproximação
Investigations to consider
- entrevista clínica estruturada/semiestruturada
Treatment algorithm
adultos com sintomas subclínicos que raramente interferem nas atividades cotidianas
adultos com sintomas frequentes que interferem em atividades cotidianas
crianças com sintomas contínuos que interferem nas atividades cotidianas
Contributors
Authors
Amy Huberman, MD
Instructor of Psychiatry
Johns Hopkins University School of Medicine
Baltimore
MD
Disclosures
AH declares that she has no competing interests.
Acknowledgements
Dr Amy Huberman would like to gratefully acknowledge Dr Eve Friedl, Dr E. Blake Zakarin, Dr Craig N. Sawchuk, and Dr Bunmi O. Olatunji, previous contributors to this topic.
Disclosures
EKF and EBZ declare that they have no competing interests. CNS is an author of a reference cited in this topic. BOO is an author of a reference cited in this topic.
Peer reviewers
Jeffrey M. Lohr, PhD
Professor
Clinical Training Program
Department of Psychology
University of Arkansas
Fayetteville
AR
Disclosures
JML declares that he has no competing interests.
David F. Tolin, PhD
Associate Professor
Institute of Living
Yale University
New Haven
CT
Disclosures
DFT declares that he has no competing interests.
References
Key articles
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.
Stinson FS, Dawson DA, Chou SP, et al. The epidemiology of DSM-IV specific phobia in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychol Med. 2007 Jul;37(7):1047-59. Abstract
Wolitzky-Taylor KB, Horowitz JD, Powers MB, et al. Psychological approaches in the treatment of specific phobias: a meta-analysis. Clin Psychol Rev. 2008 Jul;28(6):1021-37. Abstract
Katzman MA, Bleau P, Blier P, et al; Anxiety Disorders Association of Canada; McGill University. Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry. 2014;14 Suppl 1:S1.Full text Abstract
National Institute for Health and Care Excellence. Generalised anxiety disorder and panic disorder in adults: management. Clinical guideline [CG113]. June 2020 [internet publication].Full text
McMurtry CM, Taddio A, Noel M, et al. Exposure-based interventions for the management of individuals with high levels of needle fear across the lifespan: a clinical practice guideline and call for further research. Cogn Behav Ther. 2016 Apr;45(3):217-35.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Agorafobia
- Transtorno de pânico
- Transtorno da ansiedade social (fobia social)
More DifferentialsGuidelines
- Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders
- Generalised anxiety disorder and panic disorder in adults: management
More GuidelinesPatient information
Fobias
More Patient information
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