Phobias are increasingly common amongst the general population, sometimes resulting in a very significant social disability and burden for the family. Most cases remain undiagnosed, and many of those which are diagnosed are treated inappropriately.

Written by internationally renowned psychiatrist, Mario Maj, this book provides an update of research evidence and clinical experience concerning agoraphobia, social phobia and specific phobias.


This book focusing on phobias is the seventh of the WPA series “Evidence and Experience in Psychiatry”. Initiated in 1999, this series of books has involved up to now as contributors more than 700 experts from more than 60 countries, and has reached many thousands of readers in all regions of the world. All the books of the series have been translated into various languages, and a second edition of four of them have already been published.

Since the beginning, the main objective of this series of books has been to contribute to reduce the gap between research evidence and clinical practice in the management of the most common mental disorders. This objective appears particularly relevant in the case of phobic disorders. Indeed, phobias are among the most common mental disorders: in the National Comorbidity Survey, covering a national probability sample of adults in the USA, the rates of phobic disorders in the past 12 months were 8.8% for specific phobia, 7.9% for social phobia, 2.8% for agoraphobia without panic, and 2.3% for panic with or without agoraphobia. In the Netherlands Mental Health Survey, the corresponding figures were 7.1%, 4.8%, 1.6% and 2.2%.

The burden placed by phobic disorders on the patients, the families and the society at large is very significant. For instance, social phobia has been consistently associated with a lower educational attainment, a lower employment rate, a decreased work productivity and an increased financial dependency. Due to their frequently early onset, phobic disorders may interfere with the development of personal, sexual, social and intellectual functioning, and there is evidence that early-onset social phobia increases the risk for the subsequent occurrence of alcohol or drug abuse as well as major depression.

Efficacious treatments now exist for all types of phobias. Consistent evidence is available for the efficacy of in vivo exposure in treating agoraphobia, social phobia and specific phobia, and of exposure therapy plus cognitive restructuring in treating social phobia. There is good evidence for the efficacy and tolerability of a number of selective serotonin reuptake inhibitors (SSRIs) in the treatment of social phobia, and panic disorder with agoraphobia responds to SSRIs, tricyclic antidepressants and, in a selected group of patients, to benzodiazepines.

In spite of all the above, only a small minority of people with phobic disorders receive adequate treatment (among major mental disorders, only . . .

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