A) Marked fear or anxiety about two (or more) of the following five situations:
- Using public transportation (e.g., automobiles, buses, trains, ships, planes).
- Being in open spaces (e.g., parking lots, marketplaces, bridges).
- Being in enclosed places (e.g., shops, theaters, cinemas).
- Standing in line or being a crowd.
- Being outside of the home alone.
B) The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms (e.g., fear of falling in the elderly; fear of incontinence).
C) The agoraphobic situations almost always provoke fear or anxiety.
D) The agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety.
E) The fear or anxiety is out of proportion to the actual danger posed by the agoraphobic situations and to the sociocultural context.
F) The fear, anxiety, or avoidance is persistent, typically for 6 months or more.
G) The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
H) If another medical condition (e.g., inflammatory bowel disease, Parkinson’s disease) is present, the fear, anxiety, or avoidance is clearly excessive.
I) The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder-for example , the symptoms are not confined to specific phobia, situational type; do not involve only social situations (as in social anxiety disorder); and are not related exclusively to obsessions (as in obsessive-compulsive disorder), perceived defects or flaws in physical appearance (as in body dimorphic disorder), reminders of traumatic events (as in posttraumatic stress disorder), or fear of separation (as in separation anxiety disorder).
Note: Agoraphobia is diagnosed irrespective of the presence of panic disorder. If an individual’s presentation meets criteria for panic disorder and agoraphobia, both diagnoses should be assigned.