title: Bowel and bladder-control anxiety: a preliminary description of a viscerally-centred phobic syndrome.
abstract: BACKGROUND
  People with anxiety disorders occasionally report fears about losing control of basic bodily functions in public. These anxieties often occur in the absence of physical disorder and have previously been recognized as "obsessive" anxieties reflecting a preoccupation with loss of bowel/bladder control. Motivated by our observations of the non-trivial occurrence of such anxieties in our clinical practice we sought to fill a gap in the current understanding of "bowel/bladder-control anxieties".
  
  
  METHODS
  Eligible participants completed an internet survey.
  
  
  RESULTS
  Bowel/bladder-control anxieties (n = 140) tended to emerge in the mid to late 20s and were associated with high levels of avoidance and functional impairment. There was a high prevalence of panic attacks (78%); these were especially prevalent among those with bowel-control anxiety. Of those with panic attacks, 62% indicated that their main concern was being incontinent during a panic attack. Significantly, a proportion of respondents (~16%) reported actually being incontinent during a panic attack. Seventy percent of participants reported intrusive imagery related to loss of bowel/bladder control. Intrusion-related distress was correlated with agoraphobic avoidance and general role impairment. Some differences were noted between those with predominantly bowel-, predominantly bladder- and those with both bowel and bladder-control anxieties.
  
  
  CONCLUSIONS
  This preliminary characterization indicates that even in a non-treatment seeking community sample, bowel/bladder-control anxieties are associated with high levels of distress and impairment. Further careful characterization of these anxieties will clarify their phenomenology and help us develop or modify treatment protocols in a way that takes account of any special characteristics of such viscerally-centred phobic syndromes.
authors: University College London,UK.
authors: Sunjeev K
authors: SK
authors: Kamboj
authors: University College London,UK.
authors: Christine
authors: C
authors: Langhoff
authors: University College London,UK.
authors: Rosanna
authors: R
authors: Pajak
authors: University College London,UK.
authors: Alex
authors: A
authors: Zhu
authors: University College London,UK.
authors: Agnes
authors: A
authors: Chevalier
authors: University College London,UK.
authors: Sue
authors: S
authors: Watson
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000209:etiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D005242:Fecal Incontinence / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000209:etiology* / Q000523:psychology*; D011594:Psychometrics; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000523:psychology*
keywords: bladder-control anxiety