The British Journal of Psychiatry
The Classification of Phobic Disorders
ISAAC M. MARKS

Abstract

Phobias can occur in almost any situation and together with practically any other psychiatric symptom. Phobic disorders are a series of related disorders which need to be differentiated from phobic symptoms which are a minor accompaniment of another major psychiatric disturbance.

In adults mild fears are almost ubiquitous but intense phobias are uncommon. Phobic disorders in adults may conveniently be divided into Class I, those of external situations and Class II phobias, those of internal situations which cannot be escaped. Amongst phobias of external situations the agoraphobic syndrome is the commonest and most distressing phobic disorder in psychiatric practice. This is a cluster of fears which start in adult life and centre round going out alone, into public places, crowds and vehicles, occurring together in varying combinations, often with other symptoms as well. Animal phobias are rare monosymptomatic fears of a single animal species which start in childhood and persist into adult life. Social phobias are less rare, but evidence is lacking that this is a coherent group. Miscellaneous specific phobias are discrete phobias which start at any time of life. Amongst phobias of internal situations the status of illness phobias is unclear, while obsessive phobias are best classified separately with obsessive-compulsive phenomena.

Several groups of phobias of external situations can be differentiated from one another on the basis of clinical, questionnaire and psychophysiological variables.