Globus sensation and psychopathology in men: the Vietnam experience study.
OBJECTIVE
To assess whether globus is associated with psychopathology in men. Globus-a persistent sensation of having a lump in the throat with no detectable physical cause-has long been thought a predominantly female disorder. Several small studies, based wholly or largely on women, suggested that globus is associated with higher levels of depression, anxiety, and somatic concern.


METHODS
Participants were 4240 male U.S. veterans who underwent detailed medical and psychological examinations in middle age. Psychological health was assessed by structured diagnostic interview and the clinical scales of the Minnesota Multiphasic Personality Inventory (MMPI). The MMPI includes an item on the presence of globus.


RESULTS
The prevalence of globus was 6.4%. Men with globus had an increased risk of being diagnosed with somatization disorder, odds ratio (OR) = 5.92, 95% Confidence Interval (CI) = 3.22, 10.9l; major depression, OR = 4.98, 95% CI = 3.63, 6.67; generalized anxiety disorder, OR = 3.70, 95% CI = 2.75, 4.90; posttraumatic stress disorder, OR = 3.50, 95% CI = 2.54, 4.76; and drug abuse or dependence, OR = 1.89, 95% CI = 1.15, 3.13; and they scored significantly higher on nine of the ten MMPI clinical scales. Globus was also associated with lower cognitive ability, socioeconomic and educational disadvantage, a higher pulse rate, and increased likelihood of being on antihypertensive medication.


CONCLUSIONS
Globus is linked with a wide range of psychopathology in men, notably depression and somatization disorder. Men presenting with globus might have developed that particular symptom to "represent" other, related and treatable psychopathology, which should also be investigated.
Gale
Catharine R
CR
MRC Epidemiology Resource Centre, (University of Southampton) Southampton General Hospital, Southampton SO16 6YD, UK. crg@mrc.soton.ac.uk
Wilson
Janet A
JA
Deary
Ian J
IJ
D000293:Adolescent; D000328:Adult; D003130:Combat Disorders / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D003291:Conversion Disorder / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008016:Life Change Events; D008950:MMPI / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012737:Sex Factors; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data; D047829:Vietnam Conflict