Globus Pharyngeus: The Psychiatric Perspective

ABSTRACT

Globus pharyngeus or globus sensation is the painless sensation of a lump in the throat and may be described as a foreign body sensation, a tightening or choking feeling. It is often associated with persistent clearing of the throat, chronic cough, hoarseness, and catarrh. Its etiology remains unclear ; however, laryngopharyngeal reflux may play a role in a subset of patients. Psychogenic problems have often been thought to cause or trigger the globus sensation. Personality studies have found higher levels of alexithymia, neuroticism, and psychological distress (including anxiety, low mood, and somatic concerns) and lower levels of extraversion in patients presenting with globus. Globus patients with laryngopharyngeal reflux exhibited weaker psychological symptoms than non- laryngopharyngeal reflux globus patients, and globus patients who did not respond to proton pump inhibitor had significantly higher anxiety scores. In cases with negative clinical investigations and consistent globus symptom, other treatment strategies, including speech therapy, antidepressants, and cognitive-behavioral therapy, should be considered.