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ICD-10 - Phobic Anxiety Disorders

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[From World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Copyright, World Health Organization, Geneva, 1993.] ...

Agoraphobia
  1. There is marked and consistently manifest fear in, or avoidance of, at least two of the following situations:
    1. crowds;
    2. public places;
    3. traveling alone;
    4. traveling away from home.
  2. At least two symptoms of anxiety in the feared situation must have been present together, on at least one occasion since the onset of the disorder, and one of the symptoms must have been from items (1) to (4) listed below.
    Autonomic arousal symptoms
    1. palpitations or pounding heart, or accelerated heart rate;
    2. sweating;
    3. trembling or shaking;
    4. dry mouth (not due to medication or dehydration);
    Symptoms involving chest and abdomen
    1. difficulty in breathing;
    2. feeling of choking;
    3. chest pain or discomfort;
    4. nausea or abdominal distress (e.g., churning in stomach);
    Symptoms involving mental state
    1. feeling dizzy, unsteady, faint, or light-headed;
    2. feelings that objects are unreal (derealization), or that the self is distant or “not really here” (depersonalization);
    3. fear of losing control, “going crazy,” or passing out;
    4. fear of dying
    General symptoms
    1. hot flushes or cold chills;
    2. numbness or tingling sensations.
  3. Significant emotional distress is caused by the avoidance or by the anxiety symptoms, and the individual recognizes that these are excessive or unreasonable.
  4. Symptoms are restricted to, or predominate in, the feared situations or contemplation of the feared situations.
  5. Most commonly used exclusion clause. Fear or avoidance of situations (Criterion A) is not the result of delusions, hallucinations, or other disorders such as organic mental disorders, schizophrenia and related disorders, mood [affective] disorders, or obsessive-compulsive disorder, and is not secondary to cultural beliefs.
    The presence or absence of panic disorder in a majority of agoraphobic situations may be specified by using a fifth character.
    Without panic disorder
    With panic disorder
    Options for rating severity
    Severity in agoraphobia may be rated by indicating the degree of avoidance, taking into account the specific cultural setting. Severity in social phobias may be rated by counting the number of panic attacks.
Social phobias
  1. Either of the following must be present.
    1. marked fear of being the focus of attention, or fear of behaving in a way that will be embarrassing or humiliating;
    2. marked avoidance of being the focus of attention, or of situations in which there is fear of behaving in an embarrassing or humiliating way.
    These fears are manifested in social situations, such as eating or speaking in public, encountering known individuals in public or entering or enduring small group situations (e.g., parties, meetings, classrooms).
  2. At least two symptoms of anxiety in the feared situation as defined in agoraphobia, Criterion B, must have been manifest at some time since the onset of the disorder, together with at least one of the following symptoms:
    1. blushing or shaking;
    2. fear of vomiting;
    3. urgency or fear of micturition or defecation.
  3. Significant emotional distress is caused by the symptoms or by the avoidance, and the individual recognizes that these are excessive or unreasonable.
  4. Symptoms are restricted to, or predominate in, the feared situations or contemplation of the feared situations.
  5. Most commonly used exclusion clause. The symptoms listed in Criteria A and B are not the result of delusions, hallucinations, or other disorders such as organic mental disorders, schizophrenia and related disorders, mood [affective] disorders, or obsessive-compulsive disorder, and are not secondary to cultural beliefs.
Specific (isolated) phobias.
  1. Either of the following must be present:
    1. marked fear of a specific object or situation not included in agoraphobia or social phobia;
    2. marked avoidance of a specific object or situation not included in agoraphobia or social phobia.
      Among the most common objects and situations are animals, birds, insects, heights, thunder, flying, small enclosed spaces the sight of blood or injury, injections, dentists, and hospitals.
  2. Symptoms of anxiety in the feared situation as defined in agoraphobia, Criterion B, must have been manifest at some time since the onset of the disorder.
  3. Significant emotional distress is caused by the symptoms or by the avoidance, and the individual recognizes that these are excessive or unreasonable.
  4. Symptoms are restricted to the feared situation or contemplation of the feared situation. If desired, the specific phobias may be subdivided as follows. —animal type (e.g., insects, dogs)
    —nature-forces type (e.g., storms, water)
    —blood, injection, and injury type.
    —situation type (e.g., elevators, tunnels)
    —other type
Other phobic anxiety disorders
Phobic anxiety disorder, unspecified



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