The Burden of Agoraphobia in Worsening Quality of Life in a Community Survey in Italy

Abstract

Objective Current nosology redefined agoraphobia as an autonomous diagnosis distinct from panic disorder. We investigated the lifetime prevalence of agoraphobia, its association with other mental disorders, and its impact on the health-related quality of life (HR-QoL).Methods Community survey in 2,338 randomly selected adult subjects. Participants were interviewed with the Advanced Neuropsychiatric Tools and Assessment Schedule (ANTAS), administered by clinicians. The diagnoses were based on the ICD-10 criteria. The Short-Form Health Survey (SF-12) was used to quantify HR-QoL.Results In the sample, 35 subjects met the criteria for agoraphobia (1.5%), with greater prevalence among women (2.0%) than men (0.9%): odds ratio (OR) 2.23; 95% CI: 1.0-5–2. Agoraphobia was more often seen among those with (n=26; 1.1%) than without (n=9; 0.4%) panic disorder: OR=8.3; 2.9–24.4. Co-morbidity with other mental disorders was substantial. The mean score of SF-12 in people with agoraphobia was 35.2±7.8, with similar levels of HR-QoL in people with (35.3±7.9) or without (34.8±7.3) panic disorder: ANOVA: F(1;33)=0.0; p=1.00.Conclusion One out of seventy people may suffer from agoraphobia in their lifetime. The attributable burden in terms of HR-QoL is substantial and comparable to the one observed for chronic mental disorders such as major depression, post-traumatic stress disorder, or obsessive-compulsive disorder.

The impact of MDQ positivity on quality of life impairment: Does it support the hypothesis of “Dysregulation of Mood, Energy, and Social Rhythms Syndrome” (DYMERS)?

“…The total score on the SF-12 scale, measuring the health-related quality of life, was higher in controls [41.65 ± 3.39vs 35.23 ± 6.35, F (1, 75 df) = 30.337, p < 0.0001]. The mean of SF-12 overall score in MDQ positives without concomitant other psychiatric conditions was similar to that of chronic mental health and non-mental health diseases ( Table 1 ) as Wilson’s Disease, 19 Carotid Atherosclerosis, 20 Major Depressive Disorder, 21 Eating Disorders, 15 Obsessive Compulsive Disorder, 22 Post-Traumatic Stress Disorder, 23 Agoraphobia, 24 Solid Tumor, 25 and Onco-hematological tumors. 26 The perception of the health-related quality of life in MDQ positives without any psychiatric disorder was even worse than that observed in Celiac Disease, 17 Panic Disorders, 27 and Simple Phobia.…”

“…The impact of MDQ positivity (in the absence of other disorders) on worsening the quality of life was surprisingly similar to the impact seen with similar methodology and data from the same database for severe chronic disorders and diseases. 19 – 27 Only Multiple Sclerosis 18 and Fibromyalgia 29 were found to have more impact on health-related quality of life than MDQ positivity even with comorbid psychiatric disorders.…”

“…This data supports the hypothesis that MDQ positivity, by itself, identifies a condition of clinical interest regardless of comorbidity with other disorders. The dimensions explored by the SF-12 (albeit from a subjective perspective) include physical health and functioning, physical pain, vitality, social functioning, emotional condition, and 18 29.5 ± 7.3 7.0 ± 3.5 (N = 201) df 1,238 F = 9.937 p = 0.002 Wilson's disease 19 33.8 ± 9.0 4.4 ± 1.7 (N = 23) df 1,60 F = 0.344 p < 0.568 Carotid atheriosclerosis 20 30.6 ± 8.1 6.2 ± 5.0 (N = 46) df 1,83 F = 1.040 p = 0.311 Major depressive disorder 21 33.8 ± 9.2 5.6 ± 3.6 (N = 37) df 1,73 F = 2.66 p = 0.608 Eating disorders 15 34.0 ± 6.2 4.4 ± 6.6 (N = 60) df 1,97 F = 10.272 p = 0.603 Panic disorders 27 35.5 ± 4.6 2.9 ± 0.9 (N = 123) df 1,160 F = 19.454 p < 0.0001 Obsessive compulsive disorder 22 35.4 ± 6.9 2.9 ± 6.0 (N = 88) df 1,125 F = 3.709 p = 0.056 Post-traumatic stress disorder 23 36.3 ± 6.1 3.9 ± 1.0 (N = 26) df 1,91 F = 1.388 p = 0.243 Simple phobia 28 35.8 ± 6.1 2.5 ± 2.4 (N = 54) df 1,66 F = 10.016 p = 0.002 Agoraphobia 24 35. psychosocial disability. Therefore, these elements are not negligible on a clinical level.…”

Improving Quality of Life in Older Adults Living at Home by a Moderate Exercise Training

“…Only in Item 1, there was a difference with improvements in the score at T1 and regarded the experimental (exercise) group (F with df 1,103 = 3.874, with Bonferroni correction, P=0,049). In six SF-12 items, an increase of at least 10 points at T1 compared to T0 was seen in the experimental group (Item N ° 1, 6,7,9,10,11), against only 1 item in the control group (item N ° 5); In only one item in the experimental group (N° 8) a 10-point greater worsening at T1 compared to T0 was found, versus 4 items in the control group (item N° 4,6,8,9).…”