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Symptoms of swallowing anxiety in panic disorder patients and associated psychopathologic factors

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The aim of this study was to investigate symptoms of swallowing difficulty in Panic Disorder (PD) patients and the factors associated with these symptoms.


In the pre-phase of the study, 22 PD patients who were treated in psychiatry outpatient clinics and who were found to have swallowing difficulty were evaluated. PD patients were asked to write about their thoughts, feelings and behaviors associated with swallowing difficulty. Later, these texts were examined and 41 expressions were identified in which patients described their swallowing difficulty. These expressions were evaluated by mental health workers in the field and twelve different swallowing difficulty items were defined. In the main phase of the study, 119 PD outpatients were evaluated using twelve different swallowing difficulty items and psychometric tests [Panic and Agoraphobia Scale (PAS), Separation Anxiety Symptom Inventory (SASI), Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI-1/STAI-2)].


As a result of the validity and reliability analysis, a valid one-factor instrument with ten items was obtained. Cronbach’s alpha value for this measurement tool was 0.89 and it was termed the “Swallowing Anxiety Scale (SAS)”. It was found that SAS items “always” accompany PD patients at rates of 5–20.2%. According to hierarchical regression analysis, 35% of SAS scores were explained by PAS, SASI, STAI-2 and BDI scores.


Swallowing difficulty items in PD patients involved anxious, phobic and somatic symptoms associated with swallowing. In addition, swallowing difficulty symptoms in PD patients can be confounded with eating disorder symptoms.

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The authors thank everyone who provided assistance for the study including medical secretaries and psychiatry assistants.

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Correspondence to Ersin Budak.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The study was conducted in 2014 with Institutional Review Board approval.

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Written informed consent was obtained from all the participants included in this study.

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Budak, E., Taymur, İ., Önen, S. et al. Symptoms of swallowing anxiety in panic disorder patients and associated psychopathologic factors. Eat Weight Disord 23, 487–497 (2018).

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