Which statement best reflects the established treatment of a specific phobia such as fear of dogs?

• A SSRIs are the first-line treatment and should be continued for at least one year
• B Antipsychotic augmentation is required when exposure therapy fails
• C Long-term benzodiazepine therapy produces remission in most patients
• D Graded exposure-based behavioural therapy is the mainstay and drugs have little role ✓

Explanation

Specific phobia is the classic indication for behaviour therapy, particularly systematic desensitisation and graded in-vivo exposure, often with flooding as an alternative. Pharmacotherapy plays almost no role in isolated specific phobias because avoidance maintains the fear and exposure alone corrects it efficiently. SSRIs and antipsychotics have no established benefit, and chronic benzodiazepines cause dependence without producing durable remission.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.

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