Psychiatric Co-morbidities Among Patients of Globus Pharyngeus Attending Psychiatry Clinic of a Teaching Hospital

Abstract

Introduction: Globus sensation is described as a constant feeling of a lump, something stuck or foreign body in the throat associated with an uncomfortable experience of dysphagia or choking. It is a common complaint in Ear, Nose and Throat clinics. The symptom is considered functional when no apparent organic cause is detected. In that case the symptoms must be positively identified as psychologically related to some underlying mental conflict or need. The objective of this study is to evaluate the occurrence of psychiatric Co-morbidities in patients complaining of globus sensation in throat coming to psychiatric clinic.

Material and Method: A case-control study was done. Patients coming to Outpatient of psychiatry OPD which were referred from Ear, Nose and Throat Department of Lumbini Medical College Teaching Hospital with complain of globus and not having an organic explanation of the condition were included. Age, sex and socio-economic condition matched control group was selected from healthy visitors (1st degree relatives). Mini International Neuropsychiatric Interview, English version; 5.0.0.,HAM-D/HAM-A, were applied to rule out depression, anxiety and assess psychiatric co-morbidities. Final ICD-10 Criteria were done for diagnosis which were made from two psychiatrists.

Results: About 64.28 % (n=45) of globus patients had psychiatric co-morbidities which was significantly higher (p<0.0151, odds ratio 0.46) than their relatives attending with the patients. Major depressive disorder was found in 25.71% (n=18), Anxiety disorder in 22.85% (n=16), Undifferentiated somatoform disorder in 7.14 % (n=5), Dysthymia each in 7.14% (n=5), Psychosis in 1.4% (n=1), Personality Disorder in 1.4 % (n=1).

Conclusion: Burden of psychiatric co-morbidities among the patients of globus is quiet high. So, the patient who present with Globus should undergo psychiatric evaluation after organic causes have been ruled out. They should be regularly screened for psychiatric illness and an integrated treatment approach can be taken for them.