What is the psychological state of a patient with chronic pharyngitis?

  Many patients with chronic pharyngitis often have a foreign body sensation in the pharynx, which clinically becomes pharyngeal heterosensitivity. Pharyngeal heterosensitivity refers to a variety of abnormal sensations in the pharynx without obvious organic lesions, also known clinically as hysterical ball syndrome, pharyngeal ball syndrome, pharyngeal neurosis, etc., which is called “plum kernel gas” in Chinese medicine. In fact, it is also common in neurosis (hypochondria, hysteria, phobia, anxiety, depressive neurosis), depression, menopausal syndrome, schizophrenia and other functional diseases, as well as in reflux esophagitis, thyroid lesions and other systemic organic diseases. It is only a symptom of these diseases, and in the diagnosis it is necessary to exclude organic diseases before considering pharyngeal heterosensitivity, so it is used clinically as a symptom diagnosis, not as an independent disease.  The mean age of the present study was (33.90±8.04) years, with a predominance of middle-aged and young adults, which is consistent with the literature. The contemporary medical model believes that individual biological factors and external social factors must be reflected through the individual’s psychological reflection in order to play a role in human health or disease. It is also believed that only through biological, psychological and social interventions can the desired effect be achieved. The strength of the psychological response is often influenced by mediating factors such as personality traits. In this paper, the EPQ scores of N and P dimensions of patients with pharyngolaryngeal symptoms were significantly different from those of the control group (P < 0.001, P < 0.05), indicating that patients' personalities are characterized by neuroticism and psychoticism, and the rate of neuroticism is higher than that of psychoticism, indicating that patients with pharyngolaryngeal symptoms are often emotionally unstable, sensitive, suspicious, prone to anxiety, nervousness, worry, easily provoked and easily overreact to the outside world. The results suggest that patients with pharyngolaryngeal heterosensitivity are often emotionally unstable, sensitive, suspicious, easily anxious, nervous, worried, easily irritated and overly reactive to the outside world. This suggests that emotional instability, sensitivity, suspiciousness, and irritability may be the basis of the development of pharyngolaryngeal syndrome.  Clinical psychological symptoms of pharyngolaryngeal heterosensitivity: According to clinical observation, patients with pharyngolaryngeal heterosensitivity often present with psychological symptoms such as anxiety, depression, agitation, cognitive disorders, and sleep disorders. In this study, we found that patients with pharyngeal heterosensitivity disorder not only had many somatization symptoms by SCL-90, HAMD, and HAMA assessment, but also had significant psychological symptoms such as anxiety (76.47%), depression (84.31%), obsession, hostility, terror, paranoia, despair, and sleep disturbance consistent with clinical observation. Anxiety was mainly worry, nervousness, fear, and distress. Depression was mainly manifested by the desperate notion of being sad and sighing all day long, lack of confidence in treatment despite the request for treatment, and the belief that the disease could not be cured. Patients are often found to have a variety of abnormal sensations in the throat, such as obstruction, burning sensation, foreign body sensation, etc., and repeatedly go to the doctor with the dominant concept, and they are tired of asking for examination, and they are worried, painful, anxious and depressed. Many patients do not have a correct perception of the disease and often have suspicion and deny the existence of psychological factors and take a negative way of coping, so it should be considered that pharyngeal heterosensitivity disorder is the somatization of psychological disorders or the psychological result of treatment of certain physical diseases of the pharynx or adjacent tissues. There is an intensification or recovery of the nature of the change, patients suffer for this reason, worry about repeatedly seeking medical care and examination, the authors believe that this disorder is consistent with the diagnosis of somatoform disorders or somatization disorders in the Chinese classification and diagnostic criteria for psychopathology.  This study found that the disease has a long duration of (2.13±0.40) years, which may be due to the interaction between somatization symptoms and psychological symptoms, making the course of the disease a chronic fluctuating process, which hinders the improvement and recovery of the disease. Psychiatry clinical pharyngeal dissociation is common in hypochondria, hysteria, phobias, anxiety disorders, depressive neurosis, depression, menopausal syndrome, schizophrenia and other functional disorders, and the symptoms of pharyngeal dissociation often disappear when the primary disease improves with the choice of effective anxiolytic, antidepressant and antipsychotic drugs. In our clinical treatment, we found that small doses of anxiolytic and antidepressant drugs could significantly improve the symptoms in cases that were not cured for a long time.  In conclusion, the present study found that pharyngeal anomalies have a personality basis before the disease and somatization symptoms and complex psychological symptoms after the disease, and that the understanding of the disease according to the traditional biomedical model is not comprehensive.  The authors believe that ENT doctors should acquire some psychological knowledge and skills, pay attention to the psychological symptoms of the syndrome, improve the psychological symptoms and correct the personality defects of patients through psychological counseling and cognitive therapy, strive for various psychological interventions to stabilize patients' emotions while traditional somatic treatment, guide patients to correctly understand and correctly cope with abnormal sensations in the pharynx, and apply small doses of appropriate drugs when necessary. If necessary, small doses of anti-anxiety and anti-depressant drugs can be applied to help improve the psychological symptoms and contribute to the patient's improvement and recovery.