Determination of the Relationship between Globus-Type Complaints and COVID-19 Anxiety in Adult Cases with COVID-19.

INTRODUCTION: Besides generalized symptoms, patients with COVID-19 also show otolaryngological (ENT) symptoms. Globus is one of these symptoms. Anxiety problems may accompany the disease, as well. This study investigated the relationship between globus symptoms and COVID-19 anxiety in patients diagnosed with COVID-19. METHODS: The Turkish version of Glasgow-Edinburgh Throat Scale (GETS-T) and Coronavirus Anxiety Scale (CAS) was used to investigation of the relationship between globus symptoms and COVID-19 anxiety in patients diagnosed with COVID-19. They responded to the GETS-T for the evaluation of throat symptoms and determination of their severity. Additionally, it examined the level of dysfunctional anxiety associated with the coronavirus in COVID-19 patients by using the CAS. Data were collected through telephone interviews. There were 220 participants in a prospective cross-sectional study (110 COVID-19 patients and 110 non-COVID-19). RESULTS: Results show the GETS-T total score to be significantly higher in the COVID-19 group than in the non-COVID-19 group (p < 0.001). As the GETS-T total score increased, CAS total score also increased significantly in the COVID-19 group. Total scores of GETS-T and CAS were found to be lower in the post-acute period than in the acute period in the COVID-19 group (p < 0.001). CONCLUSION: This study confirms that globus-type symptoms may be present in the clinical appearance of COVID-19 infection. In addition, the results support the opinion held in the academic literature that there are positive correlations between globus sensation and psychosomatic etiology. Furthermore, the study concludes that the symptoms generalized as globus-type symptoms, which include sore throat, the feeling that something is stuck in the throat, and the inability to clear the throat, decrease and almost disappear after the first month of the disease.

Impact of systemic sclerosis oral manifestations on patients' health-related quality of life: A systematic review.

BACKGROUND: Oropharyngeal features are frequent and often understated in the treatment clinical guidelines of systemic sclerosis in spite of important consequences on comfort, aesthetics, nutrition and daily life. The aim of this systematic review was to assess a correlation between the oropharyngeal manifestations of systemic sclerosis and patients' health-related quality of life. METHODS: A systematic search was conducted using four databases [PubMed® , Cochrane Database® , Dentistry & Oral Sciences Source® and SCOPUS® ] up to January 2018, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Grey literature and hand search were also included. Study selection, risk bias assessment (Newcastle-Ottawa scale) and data extraction were performed by two independent reviewers. The review protocol was registered on PROSPERO database with the code CRD42018085994. RESULTS: From 375 screened studies, 6 cross-sectional studies were included in the systematic review. The total number of patients included per study ranged from 84 to 178. These studies reported a statistically significant association between oropharyngeal manifestations of systemic sclerosis (mainly assessed by maximal mouth opening and the Mouth Handicap in Systemic Sclerosis Scale) and an impaired quality of life (measured by different scales). Studies were unequal concerning risk of bias mostly because of low level of evidence, different recruiting sources of samples and different scales to assess the quality of life. CONCLUSION: This systematic review demonstrates a correlation between oropharyngeal manifestations of systemic sclerosis and impaired quality of life, despite the low level of evidence of included studies. Large-scaled studies are needed to provide stronger evidence of this association.

Reliability and validity of the Japanese version of the Glasgow Edinburgh Throat Scale (GETS-J): Use for a symptom scale of globus sensation.

OBJECTIVE: Globus sensation, a feeling of lump or something stuck in the throat, could be caused by structural, functional, and psychogenic diseases. Due to a possible multifactorial nature of the disease, neither diagnosing test battery nor standard treatment for globus sensation has been established. Therefore, a questionnaire to accurately identify globus patients and evaluate the severity of the disease is desired. Glasgow Edinburgh Throat Scale (GETS) is a 10-item questionnaire about the throat symptoms consisting of three subscales relating to dysphagia, globus sensation, and pain/swelling in the throat. It was reported that globus patients marked high scores specifically for the globus scale among three scales, indicating that GETS can be used as a valid symptom scale for globus sensation. Aims of this study were to translate GETS into Japanese and to test its reliability and validity. METHODS: Fifty-five patients complaining of globus sensation without abnormal endoscopic and CT findings were enrolled into the study. They were asked to answer the questions of GETS translated into Japanese (GETS-J). Reliability (internal consistency) of the questionnaire was tested using Cronbach's coefficient alpha. To test the validity, principal components analysis was used to identify the factorial structure of the questionnaire and GETS-J data were compared with those reported in the original GETS. Contribution of psychiatric comorbidities to globus sensation was also investigated by examining the correlation between Hospital Anxiety and Depression Scale (HADS) and GETS-J. RESULTS: Reliability of the questionnaire examined by the Cronbach's coefficient alpha was satisfactory and all higher than 0.75. Principal components analysis identified following three questions as the globus scale: Q1, Feeling something stuck in the throat; Q5, Throat closing off; Q9, Want to swallow all the time. Somatic distress, i.e., patients' reaction to throat symptoms, was significantly correlated with globus scale (r=0.680). Anxiety component of HADS was significantly correlated with somatic distress but not with globus scale. These results were consistent with those of the original GETS except for the replacement of Q3 (discomfort/irritation in the throat) to Q5 (throat closing off) for globus scale in GETS-J. CONCLUSION: Translation of GETS into Japanese showed high reliability and validity, suggesting that translation and cross-cultural adaptation were not problematic. High correlation of globus scale of GETS-J with somatic distress indicated that GETS-J could be a useful questionnaire to identify the globus patients and evaluate the severity of the disease. Anxiety may complicate the somatic distress in patients with globus sensation.

Serotonin Transporter Gene (SLC6A4) Polymorphism May Be Associated with Chinese Globus Pharyngeus and Its Antidepressant Effects.

BACKGROUND: Although globus pharyngeus is not rare in clinical practice, little is known about its associated gene polymorphism. We investigated the association between the SLC6A4 polymorphism and globus pharyngeus and its response to treatment with antidepressants. METHODS: A total of 84 patients were diagnosed with globus pharyngeus according to Rome III, and 160 healthy controls were genotyped for the SLC6A4 polymorphism using polymerase chain reaction amplification and agarose gel electrophoresis. All patients with globus were studied using high-resolution manometry pre-therapy. Globus patients were randomized into paroxetine or amitriptyline groups for a 6-week treatment and asked to complete the following pre- and post-therapy questionnaires: the Glasgow Edinburgh Throat Scale (GETS), the Pittsburgh Sleep Quality Index, and the Hamilton Rating Scale Anxiety/Depression. Treatment response was defined as a >50% reduction in the GETS scores. RESULTS: A significant difference was observed in the globus S/S genotype with anxiety compared to that without anxiety (χ2 = 14.579, p = 0.006). The L/S genotype showed a significant difference between high upper esophageal sphincter pressure (>104 mm Hg) and non-high upper esophageal sphincter pressure patients (χ2 = 14.433, p = 0.006). A significant association between the S/S genotype and the response to antidepressant treatment was also observed, while patients with sleep disorders or depression showed no association. CONCLUSION: A significant association was observed between the S/S genotype of the SLC6A4 polymorphism and globus pharyngeus, suggesting that SLC6A4 is a potential candidate gene involved in the pathogenesis of globus pharyngeus.

Willingness to change behaviours to reduce the risk of pharyngeal gonorrhoea transmission and acquisition in men who have sex with men: a cross-sectional survey.

OBJECTIVES: The aim of this study was to examine the willingness of men who have sex with men (MSM) to change their behaviours to potentially reduce the risk of pharyngeal gonorrhoea transmission and acquisition. METHODS: A cross-sectional questionnaire-based study was conducted among MSM attending the Melbourne Sexual Health Centre, Australia, between March and September 2015. Participants were asked how likely they would change their behaviours to reduce the risk of pharyngeal gonorrhoea. Six different potential preventive interventions were asked: (1) stop tongue kissing; (2) stop having receptive oral sex; (3) stop performing rimming; (4) stop using saliva as a lubricant during anal sex; (5) use of condoms during oral sex; and (6) use of alcohol-containing mouthwash daily. RESULTS: Of the 926 MSM who completed the questionnaire, 65.4% (95% CI 62.3% to 68.5%) expressed they were likely to use mouthwash daily to reduce the risk of pharyngeal gonorrhoea, 63.0% (95% CI 59.8% to 66.1%) would stop using saliva as a lubricant, and 49.5% (95% CI 46.2% to 52.7%) would stop rimming. In contrast, 77.6% (95% CI 74.8% to 80.3%) of MSM expressed they were unlikely to stop tongue kissing. MSM who were younger and had less male partners expressed they were unlikely to use mouthwash daily as an intervention to reduce risk of pharyngeal gonorrhoea acquisition. CONCLUSIONS: The practices MSM are willing to change to reduce the risk of pharyngeal gonorrhoea transmission and acquisition vary greatly; however, the majority of men are likely to use mouthwash daily to reduce the risk of pharyngeal gonorrhoea.

[Analysis on clinical characters of pharyngeal paraesthesia in patients with different degrees of anxiety].

Objective:To investigate the therapeutic effect and potential reason for anxiety in pharyngeal paraesthesia in patients with different degrees of anxiety based on their characteristics.Method:All patients were divided into three groups according to self-rating anxiety scale(SAS)，including group 1（mild anxiety），group 2（moderate anxiety）and group 3（severe anxiety）.The characteristics,risk factors and prognosis in each group were compared and analyzed．Meanwhile，State-Trait Anxiety Inventory(STAI)was used to analyze anxiety state of all patients and healthy participates(Group 4)．SPSS13.0 statistical software was used for data analysis. Result:The proportions of female patients(54.05%) who had anxiety symptom were higher than those of male patients(45.95%).The proportions of moderate anxiety in female patients were higher(P<0.01),but those of mild anxiety were lower(P<0.01) compared with male patients. There was no gender difference about the proportions of severe anxiety. The patients aged 40-59 years had the highest proportions of anxiety(60.14%)and a higher proportions of moderate and severe anxiety compared with the patients aged 18~39 years and over 60 years old(P<0.05).However, there was no significant difference in proportions of different degrees of anxiety between the patients aged 18-39 years and over 60 years old(P>0.05).The proportions of mild anxiety in patients with 5-10 years duration and those of moderate anxiety in patients with the course of less than 5 years were all the highest.However, no difference was found in proportions of severe anxiety among different courses(P>0.05).The proportions of moderate anxiety(except mild and severe anxiety) in patients with no fixed occupation and no senior middle school education were higher than those in patients with fixed occupation and senior middle school education or above(P<0.05).But there were no relationships between the degrees of anxiety and other general conditions of patients,including marital status and live condition. Among different degrees of anxiety,the proportions of patients who feared cancer were all the highest, followed by stress and mental stimulation factors.The proportions of patients who feared cancer and felt stress were higher in severe anxiety than those in mild and moderate anxiety.But there was no significant difference between any two groups in other related factors,including mental stimulation factors, obsessive-compulsive disorder(OCD) and family history of psychosis.Male and female patients with different degrees of anxiety compared with healthy controls respectively,had significant difference in state anxiety(SAI) scores(P<0.05),but showed no significant difference in trait anxiety(T-AI) scores(P>0.05). Both recovery rates and total effective rates of mild and moderate anxiety were higher than those of severe anxiety(P<0.01).However,there was no difference between mild and moderate anxiety whether in recovery rates or in total effective rates (P>0.05). Conclusion:Pharyngeal paraesthesia in patients with different degrees of anxiety has different clinical features and prognosis .The main cause of anxiety appears to be a long duration of treatment. No obvious anxiety potential was found in patients compared with normal people.

Comparison of paroxetine and amitriptyline in the treatment of refractory globus pharyngeus.

BACKGROUND: Clinical trials of antidepressants for treatment of globus are generally rare, let alone for refractory globus pharyngeus. AIMS: To illustrate the efficacy and side-effects of antidepressants between paroxetine and amitriptyline for refractory globus patients. METHODS: Refractory globus patients were randomized into paroxetine group; amitriptyline group and lansoprazole group for 6-week treatment. All the subjects were asked to complete the following questionnaires pre- and post-therapy: Glasgow Edinburgh Throat Scale (GETS), Pittsburgh Sleep Quality Index, Hamilton Rating Scale Anxiety/Depression and Medical outcome short-form 36. Treatment response was defined as a >50% reduction in the GETS score. RESULTS: One hundred and forty-eight patients completed the study. After 6 week treatment, 71.7% of paroxetine group (33/46) were calculated as treatment response, significantly higher than that in amitriptyline group (46.2%, 24/52) and lansoprazole group (14.0%, 7/50). Compared with lansoprazole group or amitriptyline group, a more distinct improvement of emotional well-being, quality of life and quality of sleep were observed in paroxetine group after 6-week treatment. CONCLUSION: Paroxetine therapy is more efficacious than empirical high-dose antisecretory treatment, or even the low-dose amitriptyline therapy in alleviating globus symptoms, and producing global improvements for refractory globus patients.

Concurrent Presentation of Burning Mouth Syndrome and Globus Pharyngis in Enugu, Nigeria: A Ten-year Clinical Evaluation.

PURPOSE: To review 22 patients with globus pharyngis among a group of 39 patients who presented with burning mouth syndrome and to highlight the clinical presentation and treatment outcome of these oropharyngeal symptoms, often ignored by practicing oral surgeons. PATIENTS AND METHODS: We carried out a retrospective review of 39 patients with burning mouth syndrome seen at oral surgery units of three specialist hospitals in Enugu, Nigeria between 2001 and 2010. The focus was on the 22 of these patients with burning mouth syndrome and globus pharyngis (the persistent sensation of having phlegm, a pill or some other sort of obstruction in the throat when there is none). Relevant information included patients' oral habits and dental status, past medical history, sociodemographic data, onset of symptoms and treatment outcome. RESULTS: Amongst the 22 patients, 8 (36.4%) were males while 14 (63.6%) were females, giving a male to female ratio of 1:1.8. Of the 8 male patients, 3 (37.5%) were retrenched workers, 2 (25%) were drug addicts, 2 (25%) had a history of psychiatric problems and 1 (12.5%) had post-radiation therapy due to diagnosis of adenocystic carcinoma. Amongst the 14 female patients, 6 (42.8%) were divorcees, 3 (21.4%) were unemployed and unmarried, 2 (14.3%) had menopausal problems, 2 (14.3%) had dental prostheses and 1 (7.2%) had a history of mental disorder. CONCLUSION: Globus pharyngis can present at the same time in some individuals with burning mouth syndrome. The emotional aetiological factor in this unusual ailment calls for proper examinations and a multidisciplinary approach in the management of patients who presented with burning mouth syndrome, especially with a history of depression.

Quality of life in patients with laryngopharyngeal reflux.

BACKGROUND: Laryngopharyngeal reflux (LPR) disease is an extraesophageal manifestation of gastroesophageal reflux disease (GERD). The impact of GERD-related LPR on the psychological well-being and quality of life (QOL) in Chinese is not known. AIM: To assess the QOL in patients with LPR disease. METHODS: 76 LPR and 73 healthy subjects were recruited. Psychological well-being was assessed by the Hospital Anxiety and Depression Score and QOL was assessed by SF-36. RESULTS: 51/76 (67.1%) patients had GERD-related LPR. More LPR subjects had taken sick leave (36.2 vs. 5.6%, p = 0.001) and reported adverse social life impact (60.5 vs. 38.9%, p = 0.013). LPR patients showed significantly worse results on the Voice Handicap Index (47.8 vs. 7.6, p = 0.001), were more anxious and had worse QOL in social functioning, pain and general health perception domains of SF-36. GERD-related LPR subjects had a higher depression score (4.8 vs. 3.8, p = 0.014) and a lower mental summary score (41.8 vs. 48.4, p = 0.01) in SF-36 compared with those without GERD. CONCLUSIONS: LPR had a negative impact on psychological status, social functioning and QOL. GERD symptoms appeared to be the main contributor to decrease QOL. GERD-related LPR patients had a significant impact on the mental component of their QOL.

A patient-reported outcome instrument to assess the impact of oropharyngeal mucositis on health-related quality of life: a longitudinal psychometric evaluation.

GOALS OF WORK: An oropharyngeal mucositis (OM)-specific health-related quality of life measure (OMQoL) has been developed to assess the impact of OM from the perspective of patients. The current paper describes the convergent, concurrent, and known-group validities and responsiveness in relation to clinical and health outcomes. MATERIALS AND METHODS: A multicenter approach was used, and 137 patients treated with different cancer therapies completed the OMQoL and the European Organization for Research and Treatment of Cancer Quality of Life questionnaire [EORTC QLQ-C30 (Ch)] twice over a 4-week period or weekly over a 7-week period, along with concurrent measures of OM and its related symptoms. MAIN RESULTS: The OM-related symptom scores correlated highly with the OMQoL, confirming its convergent validity (r = -0.724--0.971, p < 0.01). Moderate correlations between the subscales of the OMQoL and EORTC QLQ-C30 (Ch) were indicative of good concurrent validity (r = 0.450-0.724, p < 0.01). The OMQoL was able to distinguish between patients with different severities of OM (p < 0.01) and types of cancer therapy (p < 0.01), providing evidence of good known-group validity. The changes in effects sizes corresponding to changes in OM curves indicate that the OMQoL is responsive to changes in OM status. CONCLUSIONS: These findings suggest that the OMQoL has very good psychometric properties and can be used as a health-related quality of life assessment for cancer patients with OM. Much work is still needed in strengthening the psychometric qualities and interpretability of the OMQoL by demonstrating its ability to detect outcome changes over time.

[An analysis on SCL-90 of pharyngeal paraesthesia].

OBJECTIVE: To explore the mental health of the patients who suffered from pharyngeal paraesthesia, and investigate the effect of mental factors during the happening, development, therapy and turnover of the disease. METHOD: The Symptom Checklist 90 (SCL-90) was used to collect information,and all the data was dealed with SPSS 12.0. RESULT: (1) The total score of SCL-90 of pharyngeal paraesthesia was higher than the norm, and the score of positive items and average score of positive symptom were both significantly higher than the norm; (2) There was no differences between pharyngeal paraesthesia and the norm in terror factor while significant differences in the others; (3) There was no difference between male and female patients who suffered from pharyngeal paraesthesia. CONCLUSION: Compared with the normal, patients who suffered from pharyngeal paraesthesia had obvious mental symptoms, such as somatization, anxiety, depression et al.

Quality of life in laryngopharyngeal reflux patients.

OBJECTIVES: To evaluate and compare quality of life (QL) parameters in patients with laryngopharyngeal reflux (LPR) versus healthy controls, to determine the impact of clinical signs to QL, and to assess changes in QL parameters after treatment. STUDY DESIGN: Prospective, open, clinical study. MATERIAL AND METHODS: One hundred outpatients with LPR and 109 healthy voice controls were enrolled. LPR patients underwent endoscopy and received omeprazole for 3 months. Results of endoscopy revealed 79 patients without esophagitis and 21 with, giving two subgroups of LPR patients. QL was evaluated using voice handicap index (VHI), hospital anxiety and depression scale, disability in social activities, and well-being in general (W-BVAS). RESULTS: The mean scores for total VHI and functional, physical, and emotional functioning domain subscales were found to be significantly higher in LPR patients versus controls (P < .0001), with no difference among LPR subgroups. Abnormal anxiety was one third in both LPR subgroups versus 6.4% of controls (P < .001). Both LPR subgroups patients had significantly reduced social activities and significantly lower mean W-BVAS score than controls. LPR symptoms had a significant relation with all tested QL parameters, whereas laryngoscopic findings had a significant relation with VHI and W-BVAS only. All mean QL parameters scores improved after 3-month omeprazole treatment. CONCLUSIONS: QL in LPR patients with or without esophagitis is impaired significantly in many aspects. Impairment of QL is more associated with symptoms than laryngoscopic findings. Treatment with omeprazole significantly improved QL in both LPR subgroups patients.

What is the severity of globus sensation in individuals who have never sought health care for it?

OBJECTIVES: To assess the pattern and severity of globus-type symptoms, as measured by the Glasgow Edinburgh throat scale, in individuals who had never sought health care for a feeling of something in the throat, in order to generate the first useful normative dataset for the Glasgow Edinburgh throat scale. METHODS: One hundred and seventy-four participants recruited from non-ENT clinics completed the Glasgow Edinburgh throat scale. They were distributed among three age groups (21-45, 46-65 and >65 years). RESULTS: The commonest throat symptoms reported were 'coughing to clear the throat', followed by 'catarrh down the throat' and 'discomfort/irritation in the throat'. CONCLUSIONS: The results of the study--a normative dataset for the Glasgow Edinburgh throat scale--may form the basis for: (a) the use of the Glasgow Edinburgh throat scale in primary care to identify patients for whom referral to secondary care may be appropriate; (b) monitoring the natural history of globus sensation; and (c) assessing response to intervention, in terms of resolution to baseline population levels of symptom severity.

[Clinical classify and therapy of unusual feeling symptom of pharynx].

OBJECTIVE: Through the observation, analysis, and treatment to lots of clinical patients with unusual feeling symptom of pharynx (UFSP), followed by the functional examination of autonomic nerve, putting forward the clinical classify and therapy of UFSP. METHODS: Through the clinical history inquired, routine examination, 24 hours pH value determined of esophagus, erect experiment, and coefficient of variation of the R-R(CVR-R) examination of electrocardiogram etc, divided the UFSP into two types: the type of pathogeny clear and the type of pathogeny unclear. The clear-type was further classified into five subtypes: the type of a mental scar, the type of morbid state of mind, the type of reflux esophagitis, the type of climacteric syndrome and menstrual disorder, and the type of functional disturbance of independence nerve. RESULTS: In the cases of 256, 106 were cured,76 were positive effective, 41 were effective, with total effective rate of 87.1%. Thirty three (12.9%) cases were not cured. Forty six (18.0%) of them with the type of a mental scar were whole cured. One hundred and thirty six (53.1%) of them with the type of morbid state of mind had a 93.4% (127) effective rate. Twenty one (8.2%) of them with the type of reflux esophagitis had 71.4% (15) effective rate. Among 35 (13.7%) cases of climacteric syndrome and menstrual disorder type, 29 cases were cured with a 82.9% effective rate. Twelve (4.7%) cases of the type of functional disturbance of independence nerve had 50% effective rate. Six (2.3%) cases of the pathogeny unclear type'were not cured. CONCLUSIONS: UFSP could be clinical classified and treated followed the detail inquiry of medical history and relative examination.

Thyroidectomy does not cause globus pattern symptoms.

Post-thyroidectomy patients often complain of globus pharyngeus type symptoms. One of the organic pathologies recognized as causing globus pattern symptoms is goitre. We conducted a prospective questionnaire-based study in the thyroid clinic at Hull Royal Infirmary to examine the relationship between goitre, thyroidectomy and globus pattern symptoms by using the Glasgow-Edinburgh Throat Scale. A questionnaire-based study in which 41 consecutive patients due to undergo thyroidectomy prospectively completed the questionnaire pre-operatively and 12 months post-operatively. A subset of 25 randomly selected patients also completed the questionnaire three months post-operatively. Globus symptoms were not worsened by thyroidectomy at three or 12 months. Indeed two of the questioned parameters were significantly improved at three months, and six at one year (p < 0.023). In conclusion, thyroidectomy does not exacerbate globus pharyngeus symptoms. Indeed, in the absence of other clinical causes, when a patient has a World Health Organization (WHO) 2 goitre or greater, thyroidectomy may improve them.

Effect of Koso-san on globus pharyngeus.

Twenty-three patients with globus pharyngeus were treated with Koso-san (TJ-70) at a dose of 7.5 g/day for at least 14 days. Symptoms disappeared in 18 cases and improved in 3 cases, therefore, the effective rate was 91.3% (21/23). The symptoms disappeared on average within 13.5 days. Terasawa qi-stasis scores were significantly decreased after the treatment. TJ-70 might thus be a remedy for globus pharyngeus with qi-stasis.

Globus sensation: pharyngoesophageal function, psychometric and psychiatric findings, and follow-up in 88 patients.

BACKGROUND: The globus sensation has been widely regarded as psychogenic, but organic disorders were found to be etiologically significant. OBJECTIVE: To investigate the structural, functional, psychological, and psychiatric factors possibly eliciting the globus sensation and influencing its course. METHODS: Eighty-eight patients, 67 women and 21 men (aged 22-71 years), referred to 2 tertiary care centers underwent history taking, otolaryngological examination, pharyngoesophageal videofluoroscopy and manometry, psychosocial evaluation, psychometric tests, psychiatric interview, and when indicated, esophagogastroduodenoscopy, esophageal bolus transport, gastroesophageal reflux, and gastric emptying studies. According to revealed disorders, therapy was initiated, and the outcome was studied. RESULTS: Only 15 patients had normal pharyngoesophageal function; of these 15, 6 had chronic tonsillitis or pharyngitis, 3 had thyroid adenomata, 4 had cervical spondylosis, and 1 each had dry oropharyngeal mucosa and chronic bronchitis. Of the other 73 patients, 2 had pharyngeal dysfunction, 24 had achalasia, 1 had diffuse esophageal spasms, 3 had "nutcracker esophagus," 30 had nonspecific esophageal motor disorders, and 13 had gastroesophageal reflux. Psychometry revealed no more anxiety and depression than in general medical outpatients. Of 58 patients interviewed, 37 met criteria for psychiatric disorders. Psychometric scores and psychiatric characteristics were unrelated to the sensation's course. Therapy was recommended, but only 26 patients were treated accordingly; 22 received nonspecific treatment. Follow-up 3 to 59 months later revealed that the sensation had vanished in 13 patients who had received specific treatment, 5 who had received nonspecific treatment, and 6 who had received no treatment; it was alleviated in 10 who had received specific treatment, 13 who had received nonspecific treatment, and 9 who had received no treatment; and it was unchanged in 3 who had received specific treatment, 5 who had received nonspecific treatment, and 23 patients who had received no treatment. CONCLUSIONS: Pharyngoesophageal disorders may be sensed only vaguely, inducing the globus sensation. Psychological and psychiatric characteristics could be relevant to the discomfort experienced but are unlikely to be etiologically significant.