Globus hystericus: a brief review

Globus hystericus, a form of conversion disorder, is characterized by an uncomfortable sensation of a mass in the esophagus or airway. Evaluation proves no mass exists. Anxiety or psychological conflict is judged to be significantly related to the onset and progression of the sensation. The sensation may lead to difficulty swallowing or breathing and may become severe or life threatening. The disorder is poorly studied and understood. The differential diagnosis is vast. Management of the disorder is similar to that suggested for other conversion disorders. This article reviews the current literature about diagnosis, etiology, treatment, and prognosis of globus hystericus.

Ethical approach in contemporary psychiatry: a pragmatic approach in a psychiatry access center

The field of mental health involves many ethical issues. As health care systems change to meet the demands of managed care it will be important to address these issues. At one academic center, a new service recently created to expand psychiatric care has been developed and implemented with ongoing attention to several common and important ethical concerns. A practical approach to the provision of mental health care services in light of issues such as confidentiality, informed consent, treatment refusal, commitment, and the suicidal patient is discussed.