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Acute procedure anxiety in adults: Epidemiology and clinical presentation

Yujuan Choy, MD
Section Editor
Murray B Stein, MD, MPH
Deputy Editor
Richard Hermann, MD


Acute procedure anxiety is an excessive fear of medical, dental, or surgical procedures that results in acute distress or interference with completing necessary procedures. Patients may experience anxiety in anticipation of and/or during many types of procedures, including for screening (eg, mammography), diagnosis (eg, amniocentesis or endoscopy), and treatment (eg, angioplasty or open heart surgery).

Specific phobias are a subset of the varied manifestations of acute procedure anxiety, diagnosed under DSM-5 criteria only when the patient’s fears are specific to the procedure and its immediate effects (eg, fear of suffocation during an MRI) rather than fears not specific to the procedure itself (eg, a fear of the underlying illness that might be diagnosed). Specific phobias related to clinical procedures include blood-injection-injury phobia, dental phobia, and MRI claustrophobia.

This topic addresses the epidemiology and clinical manifestations of acute procedure anxiety in adults, related to common medical and surgical procedures. The topic includes specific phobias where the fear/anxiety is related to clinical care. Specific phobias unrelated to clinical care are discussed separately. The course, screening, assessment, diagnosis, and treatment of acute procedure anxiety are also discussed separately. (See "Acute procedure anxiety in adults: Course, screening, assessment, and differential diagnosis" and "Treatment of acute procedural anxiety in adults" and "Specific phobia in adults: Epidemiology, clinical manifestations, course and diagnosis" and "Cognitive-behavioral therapies for specific phobia in adults" and "Pharmacotherapy for specific phobia in adults".)


Acute procedure anxiety — Acute procedure anxiety, which is not a diagnosis found in DSM-5 [1], is an excessive fear and/or anxiety about a medical procedure that results in acute distress in anticipation of the procedure or during the procedure, or avoidance of the procedure. The fears experienced are often rational (eg, concern that a breast biopsy may find a malignancy), but in some cases can be irrational (eg, fear of suffocation during an MRI).

Specific phobias — Presentations of acute procedure anxiety are diagnosed as a specific phobia under DSM-5 criteria only when the focus of patients’ fear is specific to the procedure or its immediate effects (eg, a fear of seeing blood during venipuncture or suffocating during an MRI scan). A specific phobia would not be diagnosed when the patient’s fear/anxiety is about, for example, the implications or outcomes of the procedure (eg, the fear that a diagnostic procedure may detect an illness with a poor prognosis). Specific phobias related to clinical procedures include

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Literature review current through: Nov 2017. | This topic last updated: May 25, 2017.
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