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A case of choking phobia: towards a conceptual approach

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Abstract

Choking phobia, also known as phagophobia or swallowing phobia is an uncommon clinical entity that has been underappreciated and is included in the new DSM-5 and upcoming ICD-11 diagnostic category of avoidant/restrictive food intake disorder. Phenomenologically distinct from other eating disorders, it is characterized by the phobic stimulus of swallowing that results in the avoidance of food or drinks, and ultimately to low weight, social withdrawal, anxiety and depression states. Its prevalence and long-term course on the general population still needs to be determined, probably reflecting years of indefiniteness regarding its nosology and by the absence of a clear set of diagnostic criteria. We present a clinical case of choking phobia in a 32-year-old male patient after an episode of choke when eating chicken. An early diagnosis and distinction from other eating disorders is important for proper treatment and fundamental for prognosis. We also make a thorough revision on literature in clinical features, differential diagnosis and treatment approaches, suggesting a conceptual approach for choking phobia as a clinical spectrum settled by different degrees of phobic subtypes, which may depend on a varied number of clinical variables.

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Conflict of interest

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

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Authors and Affiliations

  1. Department of Psychiatry, São João Hospital, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal

    Rui Lopes, Rosário Curral, Rui Coelho & António Roma-Torres

  2. Department of Psychiatry, Divino Espirito Santo Hospital, Av. Dom Manuel I, 9500-370, Ponta Delgada, Azores, Portugal

    Raquel Melo

  3. Department of Clinical Neurosciences and Mental Health, Oporto Medical School, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal

    Rosário Curral & Rui Coelho

Authors
  1. Rui Lopes
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  2. Raquel Melo
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  3. Rosário Curral
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  4. Rui Coelho
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  5. António Roma-Torres
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Correspondence to Rui Lopes.

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Lopes, R., Melo, R., Curral, R. et al. A case of choking phobia: towards a conceptual approach. Eat Weight Disord 19, 125–131 (2014). https://doi.org/10.1007/s40519-013-0048-5

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  • DOI: https://doi.org/10.1007/s40519-013-0048-5

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