, Volume 28, Issue 2, pp 260–270 | Cite as

Diagnosis and Treatment of Phagophobia: A Review

  • Laura W. J. Baijens
  • Krista Koetsenruijter
  • Walmari Pilz
Review Article


This narrative review summarizes published studies on diagnostic examinations and therapeutic interventions for phagophobia. The electronic databases Embase, PubMed, PsycINFO®, and The Cochrane Library were used. The literature search was limited to publications in the English, German, French, Spanish, or Dutch language. The original articles are summarized in the present narrative review. The body of literature on phagophobia and swallowing fear remains very limited; only 12 studies were found. The present narrative review discovered heterogeneity in the definitions of phagophobia or similar syndromes. A systematic review, including a qualitative analysis, was planned but not carried out as studies were not of sufficient quality to warrant doing so. All the studies had severe methodological shortcomings. In general, the conclusions could not be compared across the studies because of the different study designs, small populations, different ways of evaluating and treating phagophobia, and complex combinations of treatments. A general conclusion is provided.


Phagophobia Dysphagia Deglutition Deglutition disorders Psychogenic 



The authors have no conflicts of interest to disclose.


  1. 1.
    Kim CH, Hsu JJ, Williams DE, Weaver AL, Zinsmeister AR. A prospective psychological evaluation of patients with dysphagia of various etiologies. Dysphagia. 1996;11:34–40.PubMedCrossRefGoogle Scholar
  2. 2.
    Katz PO, Dalton CB, Richter JE, Wu WC, Castell DO. Esophageal testing of patients with noncardiac chest pain or dysphagia. Results of three years’ experience with 1,161 patients. Ann Intern Med. 1987;106:593–7.PubMedCrossRefGoogle Scholar
  3. 3.
    McNally RJ. Choking phobia: a review of the literature. Compr Psychiatry. 1994;35:83–9.PubMedCrossRefGoogle Scholar
  4. 4.
    de Jongh A, ten Broeke E. Overzichtsartikel. De behandeling van stikfobie: een op de verwerking van de traumatische ervaring gerichte benadering. Tijdschr Psychiatrie. 1998;40:623–34.Google Scholar
  5. 5.
    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. text rev. Washington DC: American Psychiatric Association; 2000.Google Scholar
  6. 6.
    Evans IM, Pechtel P. Phagophobia: behavioral treatment of a complex case involving fear of fear. Clin Case Stud. 2011;10:37–52.CrossRefGoogle Scholar
  7. 7.
    Klinger RL, Strang JP. Psychiatric aspects of swallowing disorders. Psychosomatics. 1987;28:572–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Dawodu ST. Swallowing disorders. Accessed Jul 15 2011.
  9. 9.
    Wikipedia the Free Encyclopedia. Accessed Feb 2013.
  10. 10.
    Wikipedia the Free Encyclopedia. Accessed Feb 2013.
  11. 11.
    Cybulska EM. Globus hystericus or depressivus? Hosp Med. 1998;59:640–1.PubMedGoogle Scholar
  12. 12.
    Smith ME, Berke GS, Gray SD, Dove H, Harnsberger R. Clicking in the throat: cinematic fiction or surgical fact? Arch Otolaryngol Head Neck Surg. 2001;127:1129–31.PubMedCrossRefGoogle Scholar
  13. 13.
    Schluckangst Balzer W. Überlegungen zur Symptomatik und Psychodynamik der Herzphobie. Psychother Psychosom Med Psychol. 1990;40:397–400.Google Scholar
  14. 14.
    Parga F, Xesús M. Eficacia del tratamiento paralelo de dos trastornos fóbicos: Agorafobia y fobia a tragar. Análisis y Modificación de Conducta. 2001;27:983–1013.Google Scholar
  15. 15.
    Ball SG, Otto MW. Cognitive behavior treatment of choking phobia: 3 case studies. Psychother Psychosom. 1994;62:207–11.PubMedCrossRefGoogle Scholar
  16. 16.
    Bishop LC, Riley WT. The psychiatric management of the globus syndrome. Gen Hosp Psychiatry. 1988;9:214–9.CrossRefGoogle Scholar
  17. 17.
    Epstein SJ, Deyoub PL. Hypnotherapy for fear of choking: treatment implications of a case report. Int J Clin Exp Hypn. 1981;29:117–27.PubMedCrossRefGoogle Scholar
  18. 18.
    Greenberg DB, Stern TA, Weilburg JB. The fear of choking: three successfully treated cases. Psychosomatics. 1988;29:126–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Scemes S, Wielenska RC, Savoia MG, Bernik M. Choking phobia: full remission following behavior therapy. Rev Bras Psiquiatr. 2009;31:257–60.PubMedCrossRefGoogle Scholar
  20. 20.
    Shapiro J, Franko DL, Gagne A. Phagophobia: a form of psychogenic dysphagia. A new entity. Ann Otol Rhinol Laryngol. 1997;106:286–90.PubMedGoogle Scholar
  21. 21.
    Solyom L, Sookman D. Fear of choking and its treatment: a behavioural approach. Can J Psychiatry. 1980;25:30–4.PubMedGoogle Scholar
  22. 22.
    Millichap F, Lee M, Pring T. A lump in the throat: should speech and language therapists treat globus pharyngeus? Disabil Rehabil. 2005;27:124–30.PubMedCrossRefGoogle Scholar
  23. 23.
    Vaiman M, Shoval G, Gavriel H. The electrodiagnostic examination of psychogenic swallowing disorders. Eur Arch Otorhinolaryngol. 2008;265:663–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Barofsky I, Fontaine KR. Do psychogenic dysphagia patients have an eating disorder? Dysphagia. 1998;13:24–7.PubMedCrossRefGoogle Scholar
  25. 25.
    Shapiro F. EMDR: eye movement desensitization of reprocessing: basic principles, protocols and procedures. 2nd ed. New York: Guilford Press; 2001.Google Scholar
  26. 26.
    Beck AT. The past and future of cognitive therapy. J Psychother Pract Res. 1997;6:276–84.PubMedGoogle Scholar
  27. 27.
    Corah NL. Development of a dental anxiety scale. J Dent Res. 1969;48:596.PubMedCrossRefGoogle Scholar
  28. 28.
    Hamilton A. Diagnosis and rating of anxiety. Br J Psychiat Spec Publ. 1969;3:76–9.Google Scholar
  29. 29.
    Taylor JA. A personality scale of manifest anxiety. J Abnorm Psychol. 1953;153(48):285–90.Google Scholar
  30. 30.
    Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56–62.PubMedCrossRefGoogle Scholar
  31. 31.
    Deary IJ, Wilson JA, Harris MB, MacDougall G. Globus pharyngis: development of a symptom assessment scale (IS GETS!). J Psychosom Res. 1995;39:203–13.PubMedCrossRefGoogle Scholar
  32. 32.
    Guy W. Clinical Global Impressions. In: ECDEU assessment manual for psychopharmacology, revised. Rockville, MD: U.S. Department of Health, Education, and Welfare, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, National Institute of Mental Health, Psychopharmacology Research Branch, Division of Extramural Research Programs; 1976.Google Scholar
  33. 33.
    Wolpe J. The practice of behaviour therapy. 4th ed. New York: Pergamon Press; 1990.Google Scholar
  34. 34.
    Hathaway SR, McKinley JC. A multiphasic personality schedule (Minnesota): I. Construction of the schedule. J Psychol. 1940;10:249–54.CrossRefGoogle Scholar
  35. 35.
    Buck JN. House-tree-person technique: revised manual. Los Angeles: Western Psychological Services; 1966.Google Scholar
  36. 36.
    Ertekin C, Tarlaci S, Aydogdu I, Kiylioglu N, Yuceyar N, Turman AB, Secil Y, Esmeli F. Electrophysiological evaluation of pharyngeal phase of swallowing in patients with Parkinson’s disease. Mov Disord. 2002;17:942–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Laura W. J. Baijens
    • 1
  • Krista Koetsenruijter
    • 1
  • Walmari Pilz
    • 1
  1. 1.Department of Otorhinolaryngology, Head and Neck SurgeryMaastricht University Medical CenterMaastrichtThe Netherlands

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