Introduction to Phobias

Defined as a persistent and irrational fear of a specific object, activity, or situation, a phobia results in a compelling desire to avoid the perceived hazard. The patient recognizes that his fear is out of proportion to any actual danger, but he can’t control it or explain it away.
Three types of phobias exist: agoraphobia, the fear of being alone or of open space; social, the fear of embarrassing oneself in public; and specific, the fear of a single, specific object or situation, such as animals or heights.
About 7% of all Americans suffer from a phobic disorder. In fact, phobias are the most common psychiatric disorders in women and the second most common in men. More men than women experience social phobias, whereas agoraphobia and specific phobias are more common in women.
A social phobia typically begins in late childhood or early adolescence; a specific phobia usually begins in childhood. Most phobic patients have no family history of psychiatric illness, including phobias.
Agoraphobia and social phobia tend to be chronic; however, new treatments are improving the prognosis. A specific phobia usually resolves spontaneously as the child mature
Causes
A phobia develops when anxiety about an object or a situation compels the patient to avoid it. The precise cause of most phobias is unknown. Psychoanalytic theory holds that the phobia is actually repression and displacement of an internal conflict. Behavior theorists view phobia as a stimulus-response reflex, whereby the patient avoids a situation or object that causes anxiety.
Signs and symptoms
The phobic patient typically reports signs of severe anxiety when confronted with the feared object or situation. A patient with agoraphobia, for example, may complain of dizziness, a sensation of Continue reading “Introduction to Phobias”

Brief Summary of Otosclerosis

The most common cause of conductive deafness, otosclerosis is the slow formation of spongy bone in the otic capsule, particularly at the oval window. It occurs in at least 10% of the population in the United States. It commonly affects both ears and is seen in many females between the ages of 15 and 30.
Causes
Otosclerosis appears to result from a genetic factor transmitted as an autosomal dominant trait; many patients report family histories of hearing loss (excluding presbycusis). Pregnancy may trigger the onset of this condition.
Signs and symptoms
Spongy bone in the otic capsule immobilizes the footplate of the normally mobile stapes, disrupting the conduction of vibrations from the tympanic membrane to the cochlea. This causes progressive unilateral hearing loss, which may advance to bilateral deafness. Other symptoms include tinnitus and paracusis of Willis (hearing conversation better in a noisy environment than in a quiet one).
Diagnosis
Early diagnosis is based on a Rinne test that shows bone conduction lasting longer than air conduction (normally, the reverse is true). As otosclerosis progresses, bone conduction also Continue reading “Brief Summary of Otosclerosis”