title: Symptoms of swallowing anxiety in panic disorder patients and associated psychopathologic factors.
abstract: OBJECTIVE
  The aim of this study was to investigate symptoms of swallowing difficulty in Panic Disorder (PD) patients and the factors associated with these symptoms.
  
  
  METHODS
  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)].
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Psychology Department, Bursa Yüksek İhtisas Training and Research Hospital, Beşevler caddesi Elmas sokak no:1/11 Nilüfer/Bursa, 16100, Bursa, Turkey. ersin240@hotmail.com.
authors.forename: Ersin
authors.initials: E
authors.lastname: Budak
authors.affiliation: Psychiatry Department, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Taymur
authors.affiliation: Psychiatry Department, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
authors.forename: Sinay
authors.initials: S
authors.lastname: Önen
authors.affiliation: Psychiatry Department, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
authors.forename: Bilgen Biçer
authors.initials: BB
authors.lastname: Kanat
authors.affiliation: Otolaryngology Department, Bursa Esentepe Hospital, Bursa, Turkey.
authors.forename: Önder
authors.initials: Ö
authors.lastname: Akdeniz
authors.affiliation: Family Physician Department, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Demirci
mesh_terms: D000328:Adult; D001007:Anxiety / Q000150:complications* / Q000523:psychology; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000150:complications* / Q000523:psychology; D055815:Young Adult
keywords: Eating disorder; Panic disorder; Swallowing anxiety; Swallowing difficulty; Swallowing phobia