significant distress or impairment in social, occupational, or other important areas of func-
tioning (Criterion G). Th e duration of “typically lasting for 6 months or more” is meant to
exclude individuals with short-lived, transien t problems. However, the duration criterion
should be used as a general guide, with allowance for some degree of flexibility. 
Associated Features Supporting Diagnosis
In its most severe forms, agoraphobia can ca use individuals to become completely home-
bound, unable to leave their home and dependent on others for services or assistance to pro-
vide even for basic needs. Demoralization and depressive symptoms, as well as abuse of
alcohol and sedative medication as inappropriate self-medication st rategies, are common. 
Prevalence
Every year approximately 1.7% of adolescents and adults have a diagnosis of agoraphobia.
Females are twice as likely as males to expe rience agoraphobia. Agoraphobia may occur in
childhood, but incidence peaks in late ad olescence and early adulthood. Twelve-month
prevalence in individuals older than 65 year s is 0.4%. Prevalence rates do not appear to
vary systematically across cultural/racial groups.
Development and Course
The percentage of individuals with agorapho bia reporting panic attacks or panic disorder
preceding the onset of agoraphobia ranges fr om 30% in community samples to more than
50% in clinic samples. The majority of individuals with panic disorder show signs of anx-
iety and agoraphobia before the onset of panic disorder.
In two-thirds of all cases of agoraphobia, initial onset is before age 35 years. There is a
substantial incidence risk in late adolescence and early adulthood, with indications for