Table of Contents

F40-41 : Phobias

F40.0 Agoraphobia

  1. The psychological or autonomic symptoms must be primarily manifestations of anxiety and not secondary to other symptoms, such as delusions or obsessional thoughts.

  2. The anxiety must be restricted to (or occur mainly in ) at least two of the following situations:

  3. crowds

  4. public places
  5. travelling away from home
  6. travelling alone\

  7. Avoidance of the phobic situation must be, or have been, a prominent feature  

F40.1 Social phobia

  1. the psychological or autonomic symptoms must be primarily manifestations of anxiety and not secondary to other symptoms, such as delusions or obsessional thoughts.

  2. the anxiety must be restricted to or predominate in particular social situations:

  3. marked fear of being the focus of attention, or fear of behaving in a way that will be embarrassing or humiliating e.g. eating or speaking in public, encountering known individuals in public, entering small group situations.

  4. avoidance of the phobic situations must be a prominent feature.

F41.0 Panic disorder

A. A panic attack may be defined as a sudden onset of a discrete period of severe anxiety in which at least four or more of the following symptoms have been experienced:

  1. palpitations\
  2. sweating\
  3. trembling or shaking\
  4. sensation of shortness of breath\
  5. feeling of choking\
  6. chest pain / discomfort\
  7. nausea / butterflies\
  8. dizziness / lightheadedness\
  9. derealization / depersonalization\
  10. fear of losing control / going crazy\
  11. fear of dying\
  12. paraesthesia\
  13. chills or hot flushes\

B. In order to make a diagnosis of panic disorder, the patient should have experienced at least three panic attacks within a three week period. The attacks should occur:

a) in circumstances where there is no objective danger.

b) without being confined to known or predictable situations.

c) with comparative freedom from anxiety symptoms between attacks (although anticipatory anxiety is common)

F41.1 Generalized anxiety disorder

  1. The essential feature of this disorder is anxiety, which is generalized and persistent but not restricted to, or even strongly predominating in, any particular environmental circumstances (i.e. it is \"free floating\")

  2. The symptoms are variable but in order to make the diagnosis the sufferer must have primary symptoms of anxiety most days for at least several weeks at a time, and usually for several months. These symptoms should usually involve elements of:

a) apprehension (worries about future misfortunes, feeling "on edge", difficulty in concentrating etc.). b) motor tension (restless fidgeting tension headaches, trembling, inability to relax)\ c) autonomic overactivity (lightheadedness, sweating, tachycardia or tachypnoea, epigastric discomfort, dizziness, dry mouth, etc.).

  1. If symptoms of Generalized Anxiety Disorder (GAD) and Depression are present, but neither set of symptoms, considered separately, is sufficiently severe to justify a diagnosis then the category Mixed Anxiety and Depressive Disorder may be used.