Agoraphobia is a mental and behavioral disorder, specifically an anxiety disorder characterized by symptoms of anxiety in situations where the person perceives their environment to be unsafe with no easy way to escape. These situations can include open spaces, public transit, shopping centers, crowds and queues, or simply being outside their home on their own. Being in these situations may result in a panic attack. Those affected will go to great lengths to avoid these situations. In severe cases people may become completely unable to leave their homes.Agoraphobia is believed to be due to a combination of genetic and environmental factors. The condition often runs in families, and stressful or traumatic events such as the death of a parent or being attacked may be a trigger. In the DSM-5 agoraphobia is classified as a phobia along with specific phobias and social phobia. Other conditions that can produce similar symptoms include separation anxiety, post-traumatic stress disorder, and major depressive disorder. The diagnosis of agoraphobia has been shown to be comorbid with depression, substance abuse, and suicide ideation.Without treatment it is uncommon for agoraphobia to resolve. Treatment is typically with a type of counselling called cognitive behavioral therapy (CBT). CBT results in resolution for about half of people. In some instances those with a diagnosis of agoraphobia have reported taking benzodiazepines and antipsychotics augmentation. Agoraphobia affects about 1.7% of adults. Women are affected about twice as often as men. The condition often begins in early adulthood and becomes less common in old age.
Medical uses
DES has been used in the past for the following indications:
Recurrent miscarriage in pregnancy
Menopausal hormone therapy for the treatment of menopausal symptoms such as hot flashes and vaginal atrophy
Hormone therapy for hypoestrogenism (e.g., gonadal dysgenesis, premature ovarian failure, and after oophorectomy)
Postpartum lactation suppression to prevent or reverse breast engorgement
Gonorrheal vaginitis (discontinued following the introduction of the antibiotic penicillin)
Prostate cancer and breast cancer
Prevention of tall stature in tall adolescent girls
Treatment of acne in girls and women
As an emergency postcoital contraceptive
As a means of chemical castration for hypersexuality and paraphilias in men and sex offenders
Prevention of the testosterone flare at the start of gonadotropin-releasing hormone agonist (GnRH agonist) therapy
Feminizing hormone therapy for transgender womenDES was used at a dosage of 0.2 to 0.5 mg/day in menopausal hormone therapy.Interest in the use of DES to treat prostate cancer in men continues today. However, use of bioidentical parenteral estrogens like polyestradiol phosphate has been advocated in favor of oral synthetic estrogens like DES due to their much lower risk of cardiovascular toxicity. In addition to prostate cancer, some interest in the use of DES to treat breast cancer in women continues today as well.