RELATIONSHIP BETWEEN BALANCE SYSTEM FUNCTION AND AGORAPHOBIC AVOIDANCE

There is a striking similarity between the situations;avoided by peopl e with agoraphobia and the environments which provoke disorientation i n people with organic balance disorders. This study investigated the p ossibility that agoraphobia might be linked to balance system dysfunct ion by comparing the results of balance system tests in 36 people with symptoms of panic and agoraphobia and 20 normal controls. A tradition al battery of audiovestibular tests was supplemented with moving platf orm posturography, which assesses the postural instability induced by disorienting perceptual conditions. Subjects also completed questionna ire measures of somatic symptoms of dizziness and anxiety, agoraphobic cognitions, avoidance behaviour and state anxiety. Over 60% of the Ss with symptoms of panic and agoraphobia were destabilised by the disor ienting perceptual conditions, compared with just 10% of the normal co ntrols. Postural instability was strongly related to reported agorapho bic avoidance (r = 0.63, P < 0.01), even after controlling for symptom s, anxiety and agoraphobic cognitions. In our discussion we consider a lternative interpretations of these findings, future directions for re search, and implications for therapy.