A comparison of DSM-5 and DSM-IV agoraphobia in the World Mental Health Surveys: Depression and Anxiety

A.M. Roest, Y.A. de Vries, C.C.W. Lim, H.-U. Wittchen, D.J. Stein, T. Adamowski, A. Al-Hamzawi, E.J. Bromet, M.C. Viana, G. de Girolamo, K. Demyttenaere, S. Florescu, O. Gureje, J.M. Haro, C. Hu, E.G. Karam, J.M. Caldas-de-Almeida, N. Kawakami, J.P. Lépine, D. LevinsonM.E. Medina-Mora, F. Navarro-Mateu, S. O’Neill, M. Piazza, J.A. Posada-Villa, T. Slade, Y. Torres, R.C. Kessler, K.M. Scott, P. de Jonge, On behalf of the WHO World Mental Health Survey Collaborators

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Background: The Diagnostic and Statistical Manual of Mental Disorders, version 5 (DSM-5) definition of agoraphobia (AG) as an independent diagnostic entity makes it timely to re-examine the epidemiology of AG. Study objective was to present representative data on the characteristics of individuals who meet DSM-IV criteria for AG (AG without a history of panic disorder [PD] and PD with AG) but not DSM-5 criteria, DSM-5 but not DSM-IV criteria, or both sets of criteria. Methods: Population-based surveys from the World Mental Health Survey Initiative including adult respondents (n = 136,357) from 27 countries across the world. The Composite International Diagnostic Interview was used to assess AG and other disorders. Results: Lifetime and 12-month prevalence estimates of DSM-5 AG (1.5% and 1.0%) were comparable to DSM-IV (1.4% and 0.9%). Of respondents meeting criteria in either system, 57.1% met criteria in both, while 24.2% met criteria for DSM-5 only and 18.8% for DSM-IV only. Severe role impairment due to AG was reported by a lower proportion of respondents who met criteria only for DSM-IV AG (30.4%) than those with both DSM-5 and DSM-IV AG (44.0%; χ 21 = 4.7; P = 0.031). The proportion of cases with any comorbidity was lower among respondents who met criteria only for DSM-IV AG (78.7%) than those who met both sets (92.9%; χ 21= 14.5; P < 0.001). Conclusions: This first large survey shows that, compared to the DSM-IV, the DSM-5 identifies a substantial group of new cases with AG, while the prevalence rate remains stable at 1.5%. Severity and comorbidity are higher in individuals meeting DSM-5 AG criteria compared with individuals meeting DSM-IV AG criteria only. © 2019 The Authors. Depression and Anxiety Published by Wiley Periodicals, Inc.
Original languageEnglish
Pages (from-to)499-510
Number of pages12
JournalDepression and Anxiety
Issue number6
Publication statusPublished - 2019


  • agoraphobia
  • anxiety/anxiety disorders
  • cross-national
  • disorders
  • epidemiology
  • phobia/phobic
  • adult
  • aged
  • Article
  • cohort analysis
  • comorbidity
  • comparative study
  • DSM-5
  • DSM-IV
  • female
  • health survey
  • human
  • major clinical study
  • male
  • middle aged
  • prevalence
  • priority journal
  • role playing
  • adolescent
  • Diagnostic and Statistical Manual of Mental Disorders
  • global health
  • international cooperation
  • mental health
  • panic
  • young adult
  • Adolescent
  • Adult
  • Aged
  • Agoraphobia
  • Comorbidity
  • Female
  • Global Health
  • Health Surveys
  • Humans
  • Internationality
  • Male
  • Mental Health
  • Middle Aged
  • Panic Disorder
  • Prevalence
  • Young Adult


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