Specific phobias in older adults: characteristics and differential diagnosis

Coelho, Carlos M., Goncalves, Daniela C., Purkis, Helena, Pocinho, Margarida, Pachana, Nancy A. and Byrne, Gerard J (2010) Specific phobias in older adults: characteristics and differential diagnosis. International Psychogeriatrics, 22 5: 702-711. doi:10.1017/S1041610210000505

Author Coelho, Carlos M.
Goncalves, Daniela C.
Purkis, Helena
Pocinho, Margarida
Pachana, Nancy A.
Byrne, Gerard J
Title Specific phobias in older adults: characteristics and differential diagnosis
Journal name International Psychogeriatrics   Check publisher's open access policy
ISSN 1041-6102
Publication date 2010-08-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1017/S1041610210000505
Volume 22
Issue 5
Start page 702
End page 711
Total pages 10
Place of publication New York
Publisher Cambridge University Press
Language eng
Formatted abstract
Background: Differential diagnosis implies identifying shared and divergent characteristics between clinical states. Clinical work with older adults demands not only the knowledge of nosological features associated with differential diagnosis, but also recognition of idiosyncratic factors associated with this population. Several factors can interfere with an accurate diagnosis of specific phobia in older cohorts. The goal of this paper is to review criteria for specific phobia and its differential diagnosis with panic disorder, agoraphobia, post-traumatic stress disorder and obsessive compulsive disorder, while stressing the specific factors associated with aging.

A literature search regarding specific phobia in older adults was carried out using PubMed. Relevant articles were selected and scanned for further pertinent references. In addition, relevant references related to differential diagnosis and assessment were used.

Etiologic factors, specificity of feared stimulus or situation, fear predictability and the nature of phobic situations are key points to be assessed when implementing a differential diagnosis of specific phobia.

First, age-related sensory impairments are common and interfere both with information processing and communication. Second, medical illnesses create symptoms that might cause, interfere with, or mimic anxiety. Third, cohort effects might result in underreporting, through the inability to communicate or recognize anxiety symptoms, misattributing them to physical conditions. Finally, diagnostic criteria and screening instruments were usually developed using younger samples and are therefore not adapted to the functional and behavioral characteristics of older samples.
Keyword aging
differential diagnosis
obsessive compulsive disorder
panic disorder
post-traumatic stress disorder
Obsessive-compulsive Disorder
Self-rating inventory
Anxiety disorders
Panic disorder
Later life
Psychiatric disorders
Behavioral treatment
Clinical features
Elderly patients
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2011 Collection
Queensland Brain Institute Publications
School of Human Movement and Nutrition Sciences Publications
School of Medicine Publications
School of Psychology Publications
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Citation counts: TR Web of Science Citation Count  Cited 4 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 6 times in Scopus Article | Citations
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Created: Sun, 15 Aug 2010, 10:04:44 EST