Course and outcome - Agoraphobia

The condition is more common in women (up to two thirds) and often begins in the early or mid twenties. Some people do not develop the condition until the mid-thirties. Typically the condition first presents with a panic attack in a public place, when there is no obvious precipitating factoror preceding illness.

Sometimes it begins after the birth of a child, moving house or after a physical illness. Not all people with agoraphobia have panic attacks (panic disorder); some people experience marked anxiety and fear but can endure the situation, other people always take steps to avoid being in the situation in which the distressing symptoms arise.

Untreated, agoraphobia typically runs a chronic course.

Treatment seems to be most effective if instituted early in the development of the disorder, when the person is encouraged to return to the situation, which provokes the symptoms. Although people may continue to experience some mild anxiety, they are able to function normally again with treatment e.g. go shopping alone. Relapse is common but people should be offered further treatment if this occurs. People however with established symptoms lasting over one year have a poorer prognosis. These who have the condition over 5 years are likely to have life long problems, even with prolonged treatment.

20% of patients with agoraphobia eventually achieve spontaneous remission.

90% of patients with agoraphobia will experience significant improvement with treatment.