bubble_chart Overview

Phobic neurosis (commonly known as phobia) is a type of neurosis characterized by persistent and irrational fear of specific objects, activities, or situations.

bubble_chart Epidemiology

Age of onset:

Animal phobias often originate in childhood; social phobias mostly begin in late childhood [third stage] or early adolescence; agoraphobia typically occurs between the ages of 20 and 40.

Course of illness:

All three major types of phobias tend to develop into chronic conditions. Moreover, the longer the course of the illness, the poorer the treatment outcome.

bubble_chart Clinical Manifestations

The common features of this disorder are:

1. intense fear triggered by a specific object or situation;
2. the fear is often accompanied by prominent autonomic symptoms;
3. the patient is aware that the fear is unnecessary but cannot control it and still tries hard to avoid it. Clinically, there are three common types: agoraphobia, social phobia, and simple phobia.

bubble_chart Treatment Measures

1. Drug Therapy:

To control tension, anxiety, or panic attacks, imipramine 150–250 mg/d or alprazolam 1.2–2.4 mg/d may be selected. For social phobia, taking propranolol 20 mg orally one hour before entering public places has a good sedative effect.

2. Behavioral Therapy: Behavioral therapy has a good effect on this condition, with exposure therapy as the main approach. Shock therapy may also be considered as appropriate.

3. Psychotherapy

Psychotherapy is the fundamental method for treating this condition. Commonly used approaches include:

1. Group psychotherapy;
2. Small-group psychotherapy;
3. Individual psychotherapy;
4. Morita therapy.

In psychotherapy, the doctor systematically explains the medical knowledge of the condition to the patient, enabling them to fully understand the illness, analyze the causes of their symptoms, and seek solutions. This helps eliminate hypochondriacal thoughts, reduce anxiety and distress, and break the vicious cycle. The treatment methods are also explained to encourage the patient’s active cooperation and maximize therapeutic effects. Individual psychotherapy provides targeted psychological counseling based on the specific circumstances of each patient, building upon group or small-group therapy. Morita therapy, which advocates acceptance of natural emotions, is one of the effective methods for treating neurasthenia. Hospitals with the necessary conditions may also adopt this approach.

bubble_chart Differentiation

This condition needs to be differentiated from anxiety disorders, obsessive-compulsive disorder, and schizophrenia.