P-136 - Clinical polymorphisms of trasport phobias in patients of psychiatric clinics

Abstract

Transport phobias is the actual and common problem for megalopolises and large cities of Russia. Subjective severity of transport phobia frequently causes significant functional impairment and lower quality of life. To determine clinical subtypes, diagnostic categories and levels of transport phobia. 86 hospitalized patients (residents of Moscow) aged 18 to 60 with the leading pathological fear of riding in transport were included in the study. All subjects underwent psychopathological evaluation, psychological testing and follow-up. 3 subtypes of transport phobia were described: 1) mono-phobia (8,1%) - fear of one kind of transport with favorable prognostic value, 2) poly-phobia (50%)- fear of 2 or 3 kinds of transport with other psychopathological syndromes and different prognosis, 3) total transport phobia (41,9%) with unfavorable prognosis. Fear of going by underground was common initial stage and mentioned as the most anxiogenous situation. The safest mean of transport was an automobile. The course of transport phobia tends to be progressive with the transformation from mono-phobia to pan-phobia. Transport phobias developed on the basis of previous panic attaks or vegetative paroxysm with hypochondriac fears (cardio-, maniaphobia and etc.). According to ICD-10 85,5% of patients had agoraphobia with panic disorder, 14,5% - agoraphobia without panic disorder. Comorbid disorders included post-traumatic stress disorder, specific phobias, MDD and schizotypal disorder. The level of transport phobia changed from possessing fears into obsessional and overvalued. The poly-phobia occured more frequently in hospitalized patients.