[Agoraphobia and panic attacks. Biological and behavioral approaches]

Behavioral and biological issues in agoraphobia are reviewed. New classifications of agoraphobia based on longitudinal studies appear promising. Genetical studies bring some data suggesting that agoraphobia and panick attacks may be a familial and genetical disease. The effects of antidepressants on agoraphobia and panick attacks are still a disputed issue. Exposure in vivo appears as the effective component of behavioral treatment of anticipatory anxiety and allows a significant withdrawal of medication (eg antidepressant and/or benzodiazepine). A personal study on 27 agoraphobia cases is reported showing a significant rate of withdrawal after behavior therapy (p less than .05). Some examples of single case designs are reported to study the covariation of depression, phobia and panick attacks. Multicenter studies are needed to clarify the problem of effectiveness and specificity of antidepressant action on agoraphobia and panick attacks.