Skip to main content Accessibility help

Is Globus Hystericus?

  • Janet A. Wilson (a1), I. J. Deary (a2) and A. G. D. Maran (a3)


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.


Corresponding author

Level 4, Phase I, The Royal Infirmary, Edinburgh EH3 9YW


Hide All
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington DC: American Psychiatric Assocation.
Bolardos, A. C. (1964) Validation of the Maudsley Personality Inventory in Chile. British Journal of Social and Clinical Psychology, 3, 148.
Brain, Lord (1963) The concept of hysteria in the time of William Harvey. Proceedings of the Royal Society of Medicine, 56, 317324.
British Medical Journal (1986a) Use of the General Health Questionnaire in clinical work. British Medical Journal, 293, 11881189.
British Medical Journal (1986b) Hysteria: a case for conservation? British Medical Journal, 293, 12551256.
Clouse, R. E. & Lustman, P. J. (1983) Psychiatric illness and contraction abnormalities of the oesophagus. New England Journal of Medicine, 309, 13371342.
Cohen, B. R. (1973) Emotional considerations in oesophageal diseases. In Emotional Factors in Gastrointestinal Illness (ed. Under, A. E.). Amsterdam: Exerpta Medica.
Eysenck, H. J. (1944) Types of personality: a factorial study of 700 neurotics. Journal of Mental Science, 90, 851861.
Eysenck, S. B. G. (1960) Social class, sex, and response to a 5 part personality inventory. Educational and Psychological Measurement, 20, 4754.
Eysenck, H. J. (1962) Response set, authoritarianism and personality questionnaires. British Journal of Social and Clinical Psychology, 1, 2024.
Eysenck, H. J. & Eysenck, S. B. G. (1964) Manual of the Eysenck Personality Inventory. Kent: Hodder and Stoughton.
Eysenck, H. J. & Eysenck, M. W. (1985) Personality and Individual Differences. New York: Plenum Press.
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.
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.
Ford, C. V. & Folks, D. G. (1985) Conversion disorders: an overview. Psychosomatics, 26, 371383.
Glaser, J. P. & Engel, G. L. (1977) Psychodynamics, psychophysiology and gastrointestinal symptomatology. Clinical Gastroenterology, 6, 507537.
Goldberg, D. (1972) The Detection of Psychiatric Illness by Questionnaire. London: Oxford University Press.
Goldberg, D. & Hillier, V. F. (1979) A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139145.
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.
Hillebrand, H. P. (1958) A factorial study of introversion-extraversion. British Journal of Psychology, 49, 111.
Ingham, J. G. & Robinson, J. O. (1964) Personality in the diagnosis of hysteria. British Journal of Psychology, 55, 276284.
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.
Lazare, A. (1981) Current concepts in psychiatry: conversion symptoms. New England Journal of Medicine, 305, 745748.
Lehtinen, V. & Puhakka, H. (1976) A psychosomatic approach to the globus hystericus syndrome. Acta Psychiatrica Scandinavica, 53, 2128.
Lewis, A. (1975) The survival of hysteria. Psychological Medicine, 5, 912.
McEvedy, C. P., Griffith, A. & Hall, T. (1966) Two school epidemics. British Medical Journal, ii, 13001302.
McGuire, R. J., Mowbray, R. M. & Vallance, R. C. (1963) The Maudsley Personality Inventory used with psychiatric inpatients. British Journal of Psychology, 54, 157166.
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.
Malcolmson, K. G. (1966) Radiological findings in globus hystericus. British Journal of Radiology, 39, 583586.
Merskey, H. (1986) The importance of hysteria. British Journal of Psychiatry, 149, 2328.
Moloy, P. J. & Charter, R. (1982) The globus symptom. Archives of Otolaryngology, 108, 740744.
Moss, P. D. & McEvedy, C. P. (1966) An epidemic of over-breathing among schoolgirls. British Medical Journal, ii, 12951300.
Othmer, E. & DeSousa, C. (1985) A screening test for somatization disorder (hysteria). American Journal of Psychiatry, 142, 11461149.
Pennebaker, J. W. (1982) The Psychology of Physical Symptoms. New York: Springer.
Pratt, L. W., Tobin, W. H. & Gallagher, R. A. (1976) Globus hystericus – office evaluation by psychological testing with the MMPI. Laryngoscope, 86, 15401551.
Rubin, J., Nagler, R., Spiro, H. M. & Pilot, M. L. (1962) Measuring the effect of emotions on oesophageal motility. Psychosomatic Medicine, 24, 170176.
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.
Slater, E. (1965) Diagnosis of ‘hysteria’. British Medical Journal, i, 13951399.
Solyom, L. & Sookman, D. (1980) Fear of choking and its treatment. Canadian Journal of Psychiatry, 25, 3034.
Thomson, W. G. & Heaton, K. W. (1982) Heartburn and globus in apparently healthy people. Canadian Medical Association Journal, 126, 4648.
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.
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.
Wilson-Barnet, J. & Trimble, M. R. (1985) An investigation of hysteria using the illness behaviour questionnaire. British Journal of Psychiatry, 146, 601608.
Ziegler, F. J., Imboden, J. B. & Meyer, E. (1960) Contemporary conversion reactions. American Journal of Psychiatry, 116, 901910.

Related content

Powered by UNSILO

Is Globus Hystericus?

  • Janet A. Wilson (a1), I. J. Deary (a2) and A. G. D. Maran (a3)


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.

Is Globus Hystericus?

  • Janet A. Wilson (a1), I. J. Deary (a2) and A. G. D. Maran (a3)
Submit a response


No eLetters have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *