Deary I J, Wilson J A, Mitchell L, Marshall T
Department of Psychology, University of Edinburgh.
Br J Med Psychol. 1989 Dec;62(4):381-9. doi: 10.1111/j.2044-8341.1989.tb02848.x.
There is currently little agreement concerning the aetiology of globus pharyngis (née hystericus), and both physical and psychological factors have been suggested as primary causes of this common disorder. Using validated research questionnaires we tested the hypothesis that there is significant psychiatric morbidity in female globus patients but not in males. One hundred and twenty-one globus patients (90F, 31M) were tested on the Crown-Crisp Experiential Index (CCEI), the General Health Questionnaire (GHQ), the Hysteroid Obsessoid Questionnaire (HOQ) and the Eysenck Personality Questionnaire (EPQ). Female globus patients, but not males, have low extraversion scores and high GHQ scores when compared with age- and sex-matched ENT patient controls, and high mean levels of anxiety, depression and somatic concern on the CCEI. In females the mean total CCEI score was not significantly different from the mean of a psychiatric out-patient group. The males had total CCEI scores similar to a group with no psychiatric symptoms. Globus patients did not have hysteroid traits. We conclude that a substantial minority of globus patients has significant psychiatric morbidity. It is important to exclude mild, reactive-type depression and conversion disorder in these patients, in whom invasive physical investigations are inappropriate.
目前关于咽异感症（原称癔球症）的病因几乎没有共识，生理和心理因素都被认为是这种常见病症的主要病因。我们使用经过验证的研究问卷来检验这一假设，即女性咽异感症患者存在明显的精神疾病发病率，而男性则不然。对121名咽异感症患者（90名女性，31名男性）进行了皇冠-克里斯普体验指数（CCEI）、一般健康问卷（GHQ）、类癔症强迫型问卷（HOQ）和艾森克人格问卷（EPQ）测试。与年龄和性别匹配的耳鼻喉科患者对照组相比，女性咽异感症患者外向性得分低，GHQ得分高，在CCEI上焦虑、抑郁和躯体关注的平均水平较高。女性CCEI总分均值与精神科门诊患者组的均值无显著差异。男性的CCEI总分与无精神症状的一组相似。咽异感症患者没有类癔症特征。我们得出结论，相当一部分咽异感症患者存在明显的精神疾病发病率。在这些患者中排除轻度反应性抑郁和转换障碍很重要，因为对他们进行侵入性体格检查是不合适的。
