Paruresis and Parcopresis in Social Phobia: a case report

Latest thinking on paruresis and parcopresis: A new distinct diagnostic entity?

“…Similarly, parcopresis has been associated with avoidance of public and social situations. 3 The inability to initiate or sustain micturition or defecation is underpinned by an overwhelming fear of scrutiny 2a fear commonly associated with social anxiety disorder (SAD). Past research has argued that paruresis should be classified as a subtype of SAD because of overlap in symptoms 1,4 and the primarily socially anxious disposition of those with paruresis (eg avoidance strategies, overwhelming fear of negative evaluation).…”

“…Past research has argued that paruresis should be classified as a subtype of SAD because of overlap in symptoms 1,4 and the primarily socially anxious disposition of those with paruresis (eg avoidance strategies, overwhelming fear of negative evaluation). 3,7,8 Nevertheless, paruresis and SAD are likely to be two distinct conditions, as patients with paruresis do not necessarily present with comorbid SAD (approximately 5.1-22.2% of individuals with paruresis also had comorbid SAD). 2 Similarly, parcopresis is likely to be a distinct condition rather than a form of SAD.…”

“…2 A closely related condition is parcopresis, which refers to the difficulty or inability to defecate in public restrooms because of overwhelming fear of perceived scrutiny. 3 Little is known about parcopresis and prevalence of this condition has yet to be confirmed. 2 In the one case study that has been published on this condition, parcopresis has been noted to share similar characteristics with paruresis whereby there is overlap in symptomology.…”

“…2 In the one case study that has been published on this condition, parcopresis has been noted to share similar characteristics with paruresis whereby there is overlap in symptomology. 3 Key clinical features that paruresis and parcopresis patients may present with include the complaint of significant difficulty or inability to urinate or defecate in public facilities. 1 Consistent with anxiety, patients may also report avoidance behaviours and psychosomatic symptoms such as diaphoresis, tachypnea, heart palpitations, muscle tension, blushing, nausea and trembling, which occur during moments of heightened arousal (eg being inside a busy restroom).…”

“…1 Consistent with anxiety, patients may also report avoidance behaviours and psychosomatic symptoms such as diaphoresis, tachypnea, heart palpitations, muscle tension, blushing, nausea and trembling, which occur during moments of heightened arousal (eg being inside a busy restroom). 1,3,4 As a result of feelings of shame, embarrassment and a perceived stigma associated with paruresis and parcopresis, patients may be reluctant to identify and seek treatment for these conditions. General practitioners (GPs) play a critical part in identifying risk factors (eg psychological comorbidity, and family history of paruresis), 1 and helping patients to discuss and identify options to address these conditions.…”