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[Choking phobia in childhood: a differential diagnosis with anorexia nervosa]
D Bailly1, M B de Chouly de Lenclave, S Dhaussy
1Fédération de psychiatrie de l'enfant et de l'adolescent, hôpital Sainte-Marguerite, faculté de médecine de, 270 boulevard Sainte-Marguerite, 13009 Marseille, Marseille, France. slouis@ap-hm.fr <slouis@ap-hm.fr>
Introduction:
Choking phobia has been rarely described in the literature and its prevalence has not yet been determined. Because of its clinical picture (female predominance, avoidance or refusal of certain foodstuffs, secondary weight loss, associated obsessive-compulsive symptoms), it is often misdiagnosed as anorexia nervosa.
Case Report:
The authors describe the case of an 11-year-old girl, hospitalised for anorexia, who actually had choking phobia. Following a long history of anxiety disorders (including separation anxiety, social phobia, obsessive-compulsive disorder), the choking phobia had been triggered by a traumatic choking episode occurred in her grandfather. The disorder was successfully treated by cognitive-behavioural techniques associated with an antidepressant therapy.
Conclusion:
This typical case questions the relationships between choking phobia and the other anxiety disorders of childhood and adolescence. According to data from the literature, the authors conclude that choking phobia may be regarded as a non developmental specific phobia, whose occurrence is facilitated by the presence of pre-existing anxiety disorders. The disorder is usually improved by cognitive-behavioural treatment.