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Is Globus Hystericus?

Published online by Cambridge University Press:  02 January 2018

Janet A. Wilson*
University of Edinburgh Department of Otolaryngology
I. J. Deary
Department of Psychology
A. G. D. Maran
Department of Otolaryngology
Level 4, Phase I, The Royal Infirmary, Edinburgh EH3 9YW


Forty-six patients, 9 male, 37 female, presenting to an ear, nose and throat department with a principal complaint of globus sensation were investigated by radiology, manometry, endoscopy and prolonged ambulatory pH monitoring to exclude a physical basis for their symptoms. Patients also underwent assessment by the Eysenck Personality Inventory (EPI) and General Health Questionnaire (GHQ). The only organic abnormalities detected were an abnormal degree of oesophageal acid exposure (seven patients) and oesophageal spasm (one patient). Female patients were neurotic introverts on EPI testing; males were stable ambiverts. High GHQ scores were present in 13 females (35%) and one male and there was a significant correlation between N scores (in the EPI) and GHQ scores. We propose that globus is a useful, single-symptom model for the study of conversion disorders.

Research Article
Copyright © Royal College of Psychiatrists, 1988 

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American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington DC: American Psychiatric Assocation.Google ScholarPubMed
Bolardos, A. C. (1964) Validation of the Maudsley Personality Inventory in Chile. British Journal of Social and Clinical Psychology, 3, 148.CrossRefGoogle Scholar
Brain, Lord (1963) The concept of hysteria in the time of William Harvey. Proceedings of the Royal Society of Medicine, 56, 317324.Google ScholarPubMed
British Medical Journal (1986a) Use of the General Health Questionnaire in clinical work. British Medical Journal, 293, 11881189.CrossRefGoogle ScholarPubMed
British Medical Journal (1986b) Hysteria: a case for conservation? British Medical Journal, 293, 12551256.CrossRefGoogle ScholarPubMed
Clouse, R. E. & Lustman, P. J. (1983) Psychiatric illness and contraction abnormalities of the oesophagus. New England Journal of Medicine, 309, 13371342.CrossRefGoogle Scholar
Cohen, B. R. (1973) Emotional considerations in oesophageal diseases. In Emotional Factors in Gastrointestinal Illness (ed. Under, A. E.). Amsterdam: Exerpta Medica.Google Scholar
Eysenck, H. J. (1944) Types of personality: a factorial study of 700 neurotics. Journal of Mental Science, 90, 851861.Google Scholar
Eysenck, S. B. G. (1960) Social class, sex, and response to a 5 part personality inventory. Educational and Psychological Measurement, 20, 4754.CrossRefGoogle Scholar
Eysenck, H. J. (1962) Response set, authoritarianism and personality questionnaires. British Journal of Social and Clinical Psychology, 1, 2024.CrossRefGoogle ScholarPubMed
Eysenck, H. J. & Eysenck, S. B. G. (1964) Manual of the Eysenck Personality Inventory. Kent: Hodder and Stoughton.Google Scholar
Eysenck, H. J. & Eysenck, M. W. (1985) Personality and Individual Differences. New York: Plenum Press.CrossRefGoogle Scholar
Ferenczi, S. (1926) The phenomenon of hysterical materialisation. In Further Contributions to the Theory and Technique of Psychoanalysis (Int. Psychoanalytical Library No. 11), 89104. (Trans by Suttle, J. I. et al). London: L. & V. Woolf.Google Scholar
Fink, S. M. & McCallum, R. W. (1984) The role of prolonged esophageal pH monitoring in the diagnosis of gastroesophageal reflux. Journal of the American Medical Association, 252, 11601164.CrossRefGoogle Scholar
Ford, C. V. & Folks, D. G. (1985) Conversion disorders: an overview. Psychosomatics, 26, 371383.CrossRefGoogle ScholarPubMed
Glaser, J. P. & Engel, G. L. (1977) Psychodynamics, psychophysiology and gastrointestinal symptomatology. Clinical Gastroenterology, 6, 507537.Google ScholarPubMed
Goldberg, D. (1972) The Detection of Psychiatric Illness by Questionnaire. London: Oxford University Press.Google ScholarPubMed
Goldberg, D. & Hillier, V. F. (1979) A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139145.CrossRefGoogle ScholarPubMed
Gray, L. P. (1983) The relationship of the inferior constrictor swallow and ‘globus hystericus’ or the hypopharyngeal syndrome. Journal of Laryngology and Otology, 97, 607618.CrossRefGoogle ScholarPubMed
Hillebrand, H. P. (1958) A factorial study of introversion-extraversion. British Journal of Psychology, 49, 111.CrossRefGoogle Scholar
Ingham, J. G. & Robinson, J. O. (1964) Personality in the diagnosis of hysteria. British Journal of Psychology, 55, 276284.CrossRefGoogle Scholar
Kaplan, P. R. & Evans, I. M. (1978) A case of functional dysphagia treated on the model of fear. Journal of Behavioural Therapeutic and Experimental Psychiatry, 9, 7172.CrossRefGoogle Scholar
Lazare, A. (1981) Current concepts in psychiatry: conversion symptoms. New England Journal of Medicine, 305, 745748.CrossRefGoogle ScholarPubMed
Lehtinen, V. & Puhakka, H. (1976) A psychosomatic approach to the globus hystericus syndrome. Acta Psychiatrica Scandinavica, 53, 2128.CrossRefGoogle ScholarPubMed
Lewis, A. (1975) The survival of hysteria. Psychological Medicine, 5, 912.CrossRefGoogle ScholarPubMed
McEvedy, C. P., Griffith, A. & Hall, T. (1966) Two school epidemics. British Medical Journal, ii, 13001302.CrossRefGoogle Scholar
McGuire, R. J., Mowbray, R. M. & Vallance, R. C. (1963) The Maudsley Personality Inventory used with psychiatric inpatients. British Journal of Psychology, 54, 157166.CrossRefGoogle Scholar
Mair, I. W. S., Schroder, K. E., Modalsli, B. & Maurer, H.-J. (1974) Aetiological aspects of the globus symptom. Journal of Laryngology and Otology, 88, 10331054.CrossRefGoogle ScholarPubMed
Malcolmson, K. G. (1966) Radiological findings in globus hystericus. British Journal of Radiology, 39, 583586.CrossRefGoogle Scholar
Merskey, H. (1986) The importance of hysteria. British Journal of Psychiatry, 149, 2328.CrossRefGoogle ScholarPubMed
Moloy, P. J. & Charter, R. (1982) The globus symptom. Archives of Otolaryngology, 108, 740744.CrossRefGoogle ScholarPubMed
Moss, P. D. & McEvedy, C. P. (1966) An epidemic of over-breathing among schoolgirls. British Medical Journal, ii, 12951300.CrossRefGoogle Scholar
Othmer, E. & DeSousa, C. (1985) A screening test for somatization disorder (hysteria). American Journal of Psychiatry, 142, 11461149.Google Scholar
Pennebaker, J. W. (1982) The Psychology of Physical Symptoms. New York: Springer.CrossRefGoogle Scholar
Pratt, L. W., Tobin, W. H. & Gallagher, R. A. (1976) Globus hystericus – office evaluation by psychological testing with the MMPI. Laryngoscope, 86, 15401551.CrossRefGoogle ScholarPubMed
Rubin, J., Nagler, R., Spiro, H. M. & Pilot, M. L. (1962) Measuring the effect of emotions on oesophageal motility. Psychosomatic Medicine, 24, 170176.CrossRefGoogle Scholar
Sigal, J. J., Kolman, H. S. & Franks, C. M. (1958) Hysterics and dysthymics as criterion groups in the study of introversion-extraversion. Journal of Abnormal and Social Psychology, 57, 143148.CrossRefGoogle Scholar
Slater, E. (1965) Diagnosis of ‘hysteria’. British Medical Journal, i, 13951399.CrossRefGoogle Scholar
Solyom, L. & Sookman, D. (1980) Fear of choking and its treatment. Canadian Journal of Psychiatry, 25, 3034.CrossRefGoogle ScholarPubMed
Thomson, W. G. & Heaton, K. W. (1982) Heartburn and globus in apparently healthy people. Canadian Medical Association Journal, 126, 4648.Google Scholar
Wilson, J. A., Murray, J. A. M. & von Haacke, N. P. (1987a) Rigid endoscopy in ENT practice: appraisal of the diagnostic yield in a district general hospital. Journal of Laryngology and Otology, 101, 286292.CrossRefGoogle Scholar
Wilson, J. A., Maran, A. G. D., Pryde, A., Piris, J., Allan, P. L. & Heading, R. C. (1987b) Globus sensation is not due to gastroesophageal reflux. Clinical Otolaryngology, 12, 271275.CrossRefGoogle ScholarPubMed
Wilson-Barnet, J. & Trimble, M. R. (1985) An investigation of hysteria using the illness behaviour questionnaire. British Journal of Psychiatry, 146, 601608.CrossRefGoogle Scholar
Ziegler, F. J., Imboden, J. B. & Meyer, E. (1960) Contemporary conversion reactions. American Journal of Psychiatry, 116, 901910.CrossRefGoogle ScholarPubMed
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