Emetophobia: A critical review about an understudied disorder

Abstract

Introduction: Emetophobia or fear of vomit - which includes an excessive fear of vomiting or seeing other people vomiting and can be triggered by internal and external stimuli -is a complex and fairly unknown disorder. Objective: This study aimed at reviewing the current knowledge about this condition. Method: A conventional literature review of the previous 30 years, using as search strategy the following keywords: "emetophobia", "emetophobic", "fear of vomiting", "vomiting phobia", and "phobia of vomit". All articles about the epidemiology, phenomenology, differential diagnosis and treatment of emetophobia were included, as well as articles cited in these ones. Results: There are no available data on the prevalence in the general population and little is known about the etiology of emetophobia. Most studies describe predominance in females, early onset and chronic course. The avoidant behaviors can have a significant impact on occupational, social and family lives. The most important differential diagnoses are: panic isorder with agoraphobia, social phobia, anorexia nervosa and obsessive-compulsive disorder. Treatment studies are mostly case reports and no controlled clinical trials have been published. Cognitive-behavioral interventions, however, seem to be promising. Conclusion: More studies are needed for a better understanding of the epidemiology, clinical picture, etiology, classification and treatment of emetophobia.