Phobic Disorders Differential Diagnoses

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association Press; 2000.

2. Mathew SJ, Coplan JD, Gorman JM. Neurobiological mechanisms of social anxiety disorder. Am J Psychiatry. 2001 Oct. 158(10):1558-67. [QxMD MEDLINE Link].

3. Kendler KS, Karkowski LM, Prescott CA. Fears and phobias: reliability and heritability. Psychol Med. 1999 May. 29(3):539-53. [QxMD MEDLINE Link].

4. Fyer AJ, Mannuzza S, Chapman TF, Liebowitz MR, Klein DF. A direct interview family study of social phobia. Arch Gen Psychiatry. 1993 Apr. 50(4):286-93. [QxMD MEDLINE Link].

5. Van Houtem CM, Laine ML, Boomsma DI, Ligthart L, van Wijk AJ, De Jongh A. A review and meta-analysis of the heritability of specific phobia subtypes and corresponding fears. J Anxiety Disord. 2013 May. 27(4):379-88. [QxMD MEDLINE Link].

6. LeBeau RT, Glenn D, Liao B, et al. Specific phobia: a review of DSM-IV specific phobia and preliminary recommendations for DSM-V. Depress Anxiety. 2010 Feb. 27(2):148-67. [QxMD MEDLINE Link].

7. Linares IM, Trzesniak C, Chagas MH, Hallak JE, Nardi AE, Crippa JA. Neuroimaging in specific phobia disorder: a systematic review of the literature. Rev Bras Psiquiatr. 2012 Mar. 34(1):101-11. [QxMD MEDLINE Link].

8. Lanzenberger RR, Mitterhauser M, Spindelegger C, Wadsak W, Klein N, Mien LK, et al. Reduced serotonin-1A receptor binding in social anxiety disorder. Biol Psychiatry. 2007 May 1. 61(9):1081-9. [QxMD MEDLINE Link].

9. Lanzenberger R, Wadsak W, Spindelegger C, Mitterhauser M, Akimova E, Mien LK, et al. Cortisol plasma levels in social anxiety disorder patients correlate with serotonin-1A receptor binding in limbic brain regions. Int J Neuropsychopharmacol. 2010 Oct. 13(9):1129-43. [QxMD MEDLINE Link].

10. Freitas-Ferrari MC, Hallak JE, Trzesniak C, Filho AS, Machado-de-Sousa JP, Chagas MH, et al. Neuroimaging in social anxiety disorder: a systematic review of the literature. Prog Neuropsychopharmacol Biol Psychiatry. 2010 May 30. 34(4):565-80. [QxMD MEDLINE Link].

11. Kim YK, Yoon HK. Common and distinct brain networks underlying panic and social anxiety disorders. Prog Neuropsychopharmacol Biol Psychiatry. 2018 Jan 3. 80 (Pt B):115-122. [QxMD MEDLINE Link].

12. Ahs F, Pissiota A, Michelgård A, Frans O, Furmark T, Appel L, et al. Disentangling the web of fear: amygdala reactivity and functional connectivity in spider and snake phobia. Psychiatry Res. 2009 May 15. 172(2):103-8. [QxMD MEDLINE Link].

13. Kim YK, Yoon HK. Common and distinct brain networks underlying panic and social anxiety disorders. Prog Neuropsychopharmacol Biol Psychiatry. 2018 Jan 3. 80 (Pt B):115-122. [QxMD MEDLINE Link].

14. Kessler RC, Petukhova M, Sampson NA, Zaslavsky AM, Wittchen HU. Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. Int J Methods Psychiatr Res. 2012 Sep. 21(3):169-84. [QxMD MEDLINE Link]. [Full Text].

15. Lewis-Fernández R, Hinton DE, Laria AJ, et al. Culture and the anxiety disorders: recommendations for DSM-V. Depress Anxiety. 2010 Feb. 27(2):212-29. [QxMD MEDLINE Link].

16. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005 Jun. 62(6):593-602. [QxMD MEDLINE Link].

17. Wolitzky-Taylor KB, Castriotta N, Lenze EJ, Stanley MA, Craske MG. Anxiety disorders in older adults: a comprehensive review. Depress Anxiety. 2010 Feb. 27(2):190-211. [QxMD MEDLINE Link].

18. Ruscio AM, Brown TA, Chiu WT, Sareen J, Stein MB, Kessler RC. Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication. Psychol Med. 2008 Jan. 38(1):15-28. [QxMD MEDLINE Link]. [Full Text].

19. Ollendick TH, King NJ, Muris P. Fears and phobias in children: phenomenology, epidemiology and aetiology. Child Adolesc Ment Health. 2002. 7:98–106.

20. Wittchen HU, Jacobi F, Rehm J, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011 Sep. 21(9):655-79. [QxMD MEDLINE Link].

21. Beesdo K, Knappe S, Pine DS. Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. Psychiatr Clin North Am. 2009 Sep. 32(3):483-524. [QxMD MEDLINE Link]. [Full Text].

22. Kessler RC, Chiu WT, Jin R, Ruscio AM, Shear K, Walters EE. The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2006 Apr. 63(4):415-24. [QxMD MEDLINE Link]. [Full Text].

23. Fehm L, Pelissolo A, Furmark T, Wittchen HU. Size and burden of social phobia in Europe. Eur Neuropsychopharmacol. 2005 Aug. 15(4):453-62. [QxMD MEDLINE Link].

24. Wittchen HU, Stein MB, Kessler RC. Social fears and social phobia in a community sample of adolescents and young adults: prevalence, risk factors and co-morbidity. Psychol Med. 1999 Mar. 29(2):309-23. [QxMD MEDLINE Link].

25. Wittchen HU, Gloster AT, Beesdo-Baum K, Fava GA, Craske MG. Agoraphobia: a review of the diagnostic classificatory position and criteria. Depress Anxiety. 2010 Feb. 27(2):113-33. [QxMD MEDLINE Link].

26. Bruce SE, Yonkers KA, Otto MW, Eisen JL, Weisberg RB, Pagano M, et al. Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study. Am J Psychiatry. 2005 Jun. 162(6):1179-87. [QxMD MEDLINE Link].

27. Vriends N, Bolt OC, Kunz SM. Social anxiety disorder, a lifelong disorder? A review of the spontaneous remission and its predictors. Acta Psychiatr Scand. 2014 Aug. 130 (2):109-22. [QxMD MEDLINE Link].

28. Sigström R, Östling S, Karlsson B, Waern M, Gustafson D, Skoog I. A population-based study on phobic fears and DSM-IV specific phobia in 70-year olds. J Anxiety Disord. 2011 Jan. 25 (1):148-53. [QxMD MEDLINE Link].

29. Wolitzky-Taylor KB, Horowitz JD, Powers MB, Telch MJ. Psychological approaches in the treatment of specific phobias: a meta-analysis. Clin Psychol Rev. 2008 Jul. 28 (6):1021-37. [QxMD MEDLINE Link].

30. Schneier FR, Heckelman LR, Garfinkel R, Campeas R, Fallon BA, Gitow A, et al. Functional impairment in social phobia. J Clin Psychiatry. 1994 Aug. 55(8):322-31. [QxMD MEDLINE Link].

31. Lochner C, Mogotsi M, du Toit PL, Kaminer D, Niehaus DJ, Stein DJ. Quality of life in anxiety disorders: a comparison of obsessive-compulsive disorder, social anxiety disorder, and panic disorder. Psychopathology. 2003 Sep-Oct. 36(5):255-62. [QxMD MEDLINE Link].

32. Matza LS, Revicki DA, Davidson JR, Stewart JW. Depression with atypical features in the National Comorbidity Survey: classification, description, and consequences. Arch Gen Psychiatry. 2003 Aug. 60(8):817-26. [QxMD MEDLINE Link].

33. Sareen J, Cox BJ, Afifi TO, de Graaf R, Asmundson GJ, ten Have M, et al. Anxiety disorders and risk for suicidal ideation and suicide attempts: a population-based longitudinal study of adults. Arch Gen Psychiatry. 2005 Nov. 62(11):1249-57. [QxMD MEDLINE Link].

34. Stein MB, Stein DJ. Social anxiety disorder. Lancet. 2008 Mar 29. 371(9618):1115-25. [QxMD MEDLINE Link].

35. Beesdo K, Bittner A, Pine DS, Stein MB, Höfler M, Lieb R, et al. Incidence of social anxiety disorder and the consistent risk for secondary depression in the first three decades of life. Arch Gen Psychiatry. 2007 Aug. 64(8):903-12. [QxMD MEDLINE Link].

36. Magee WJ, Eaton WW, Wittchen HU, McGonagle KA, Kessler RC. Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. Arch Gen Psychiatry. 1996 Feb. 53(2):159-68. [QxMD MEDLINE Link].

37. Liotti G. Phobias of Attachment-Related Inner States in the Psychotherapy of Adult Survivors of Childhood Complex Trauma. J Clin Psychol. 2013 Aug 28. [QxMD MEDLINE Link].

38. Baldwin DS, Anderson IM, Nutt DJ, Bandelow B, Bond A, Davidson JR, et al. Evidence-based guidelines for the pharmacological treatment of anxiety disorders: recommendations from the British Association for Psychopharmacology. J Psychopharmacol. 2005 Nov. 19(6):567-96. [QxMD MEDLINE Link].

39. de Beurs E, van Balkom AJ, Van Dyck R, Lange A. Long-term outcome of pharmacological and psychological treatment for panic disorder with agoraphobia: a 2-year naturalistic follow-up. Acta Psychiatr Scand. 1999 Jan. 99(1):59-67. [QxMD MEDLINE Link].

40. Pelissolo A. [Efficacy and tolerability of escitalopram in anxiety disorders: a review]. Encephale. 2008 Sep. 34(4):400-8. [QxMD MEDLINE Link].

41. National Prescribing Service Limited. Escitalopram (Lexapro, Esipram) for generalised anxiety disorder and social anxiety disorder (social phobia). NPS RADAR. Available at http://bit.ly/dOARMJ.

42. Stein DJ, Ipser JC, van Balkom AJ. Pharmacotherapy for social anxiety disorder. Cochrane Review. Chichester, UK: John Wiley and Sons, Ltd; 2009.

43. Westenberg HG. Recent advances in understanding and treating social anxiety disorder. CNS Spectr. 2009 Feb. 14(2 Suppl 3):24-33. [QxMD MEDLINE Link].

44. Ravindran LN, Stein MB. The pharmacologic treatment of anxiety disorders: a review of progress. J Clin Psychiatry. 2010 Jul. 71(7):839-54. [QxMD MEDLINE Link].

45. Davidson JR. Pharmacotherapy of social anxiety disorder: what does the evidence tell us?. J Clin Psychiatry. 2006. 67 Suppl 12:20-6. [QxMD MEDLINE Link].

46. Offidani E, Guidi J, Tomba E, Fava GA. Efficacy and Tolerability of Benzodiazepines versus Antidepressants in Anxiety Disorders: A Systematic Review and Meta-Analysis. Psychother Psychosom. 2013 Sep 20. 82(6):355-362. [QxMD MEDLINE Link].

47. Van Ameringen M, Allgulander C, Bandelow B, Greist JH, Hollander E, Montgomery SA, et al. WCA recommendations for the long-term treatment of social phobia. CNS Spectr. 2003 Aug. 8(8 Suppl 1):40-52. [QxMD MEDLINE Link].

48. Practice guideline for the treatment of patients with panic disorder. Work Group on Panic Disorder. American Psychiatric Association. Am J Psychiatry. 1998 May. 155(5 Suppl):1-34. [QxMD MEDLINE Link].

49. Pohl RB, Wolkow RM, Clary CM. Sertraline in the treatment of panic disorder: a double-blind multicenter trial. Am J Psychiatry. 1998 Sep. 155(9):1189-95. [QxMD MEDLINE Link].

50. Michelson D, Lydiard RB, Pollack MH, Tamura RN, Hoog SL, Tepner R, et al. Outcome assessment and clinical improvement in panic disorder: evidence from a randomized controlled trial of fluoxetine and placebo. The Fluoxetine Panic Disorder Study Group. Am J Psychiatry. 1998 Nov. 155(11):1570-7. [QxMD MEDLINE Link].

51. Uhlenhuth EH, Balter MB, Ban TA, Yang K. International study of expert judgment on therapeutic use of benzodiazepines and other psychotherapeutic medications: VI. Trends in recommendations for the pharmacotherapy of anxiety disorders, 1992-1997. Depress Anxiety. 1999. 9(3):107-16. [QxMD MEDLINE Link].

52. Shear MK, Beidel DC. Psychotherapy in the overall management strategy for social anxiety disorder. J Clin Psychiatry. 1998. 59 Suppl 17:39-46. [QxMD MEDLINE Link].

53. [Guideline] Mayor S. NICE advocates computerised CBT. BMJ. 2006 Mar 4. 332(7540):504. [QxMD MEDLINE Link]. [Full Text].

54. Barlow JH, Ellard DR, Hainsworth JM, Jones FR, Fisher A. A review of self-management interventions for panic disorders, phobias and obsessive-compulsive disorders. Acta Psychiatr Scand. 2005 Apr. 111(4):272-85. [QxMD MEDLINE Link].

55. Masia Warner C, Fisher PH, Shrout PE, Rathor S, Klein RG. Treating adolescents with social anxiety disorder in school: an attention control trial. J Child Psychol Psychiatry. 2007 Jul. 48(7):676-86. [QxMD MEDLINE Link].

56. Bunnell BE, Beidel DC, Mesa F. A Randomized Trial of Attention Training for Generalized Social Phobia: Does Attention Training Change Social Behavior?. Behav Ther. 2013 Dec. 44(4):662-673. [QxMD MEDLINE Link].

57. Ayala ES, Meuret AE, Ritz T. Treatments for blood-injury-injection phobia: a critical review of current evidence. J Psychiatr Res. 2009 Oct. 43(15):1235-42. [QxMD MEDLINE Link].

58. Rothbaum BO, Anderson P, Zimand E, Hodges L, Lang D, Wilson J. Virtual reality exposure therapy and standard (in vivo) exposure therapy in the treatment of fear of flying. Behav Ther. 2006 Mar. 37(1):80-90. [QxMD MEDLINE Link].

59. Paquette V, Lévesque J, Mensour B, Leroux JM, Beaudoin G, Bourgouin P, et al. "Change the mind and you change the brain": effects of cognitive-behavioral therapy on the neural correlates of spider phobia. Neuroimage. 2003 Feb. 18(2):401-9. [QxMD MEDLINE Link].

60. Schienle A, Schäfer A, Hermann A, Rohrmann S, Vaitl D. Symptom provocation and reduction in patients suffering from spider phobia: an fMRI study on exposure therapy. Eur Arch Psychiatry Clin Neurosci. 2007 Dec. 257(8):486-93. [QxMD MEDLINE Link].

61. Sánchez-Meca J, Rosa-Alcázar AI, Marín-Martínez F, Gómez-Conesa A. Psychological treatment of panic disorder with or without agoraphobia: a meta-analysis. Clin Psychol Rev. 2010 Feb. 30(1):37-50. [QxMD MEDLINE Link].

62. Hudson C, Hudson S, MacKenzie J. Protein-source tryptophan as an efficacious treatment for social anxiety disorder: a pilot study. Can J Physiol Pharmacol. 2007 Sep. 85(9):928-32. [QxMD MEDLINE Link].

63. Straube T, Mentzel HJ, Miltner WH. Waiting for spiders: brain activation during anticipatory anxiety in spider phobics. Neuroimage. 2007 Oct 1. 37(4):1427-36. [QxMD MEDLINE Link].

Adrian Preda, MD Professor of Clinical Psychiatry and Human Behavior, University of California, Irvine, School of Medicine

Adrian Preda, MD is a member of the following medical societies: American Association for the Advancement of Science, American Psychiatric Association, International College of Neuropsychopharmacology, International Congress of Schizophrenia Research, Schizophrenia International Research Society, Society of Biological Psychiatry

Disclosure: Nothing to disclose.

David Bienenfeld, MD Professor, Departments of Psychiatry and Geriatric Medicine, Wright State University, Boonshoft School of Medicine

David Bienenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, Association for Academic Psychiatry

Disclosure: Nothing to disclose.

Mohammed A Memon, MD Chairman and Attending Geriatric Psychiatrist, Department of Psychiatry, Spartanburg Regional Medical Center

Mohammed A Memon, MD is a member of the following medical societies: American Association for Geriatric Psychiatry, American Medical Association, and American Psychiatric Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

• Print this section
• Print the entire contents of
• Print the entire contents of article