Psychogenic Urinary Retention (‘Paruresis’): Diagnosis and Epidemiology in a Representative Male Sample

Abstract

Background: Although research interest in social phobias has expanded during the last decade, a special subtype of social phobia known as paruresis, which manifests in the inability to urinate in public rest rooms, is rarely mentioned. The aim of the present study was to achieve for the first time an estimation of point prevalence in a representative male sample (n = 1,105). Method: Due to the lack of well-established screening instruments for paruresis, the Paruresis Checklist (PCL) must be tested for reliability and validity. An empirically based cutoff score must be determined by using the subjective interference with everyday life as an external criterion. Results: Reliability of the PCL seemed to be sufficient, and adequate evidence for validity was found. Using the empirically based cutoff score of the PCL, 2.8% of the sample was diagnosed as suffering from paruresis. In contrast to other forms of social phobia, paruresis is not associated with a lower educational or occupational level.

Paruresis and Parcopresis in Social Phobia: a case report

“…Currently, these disorders fall under the category of social phobia. 3 As paruresis and parcopresis have a low prevalence (approximately 3%) in patients with anxiety disorders 4 the diagnosis of these events is not easily achieved by health professionals. The main reasons for underdiagnosis are the false association with organic disease, the limited knowledge of the diseases on the part of health professionals and the difficulty for the patients to seek help.…”

“…The main reasons for underdiagnosis are the false association with organic disease, the limited knowledge of the diseases on the part of health professionals and the difficulty for the patients to seek help. 4 Treatment is hampered by the resistance of patients to recognize the problem and the limited therapeutic response in a proportion of cases. Pharmacological treatment recommends the use of selective serotonin reuptake inhibitors, β -blockers and other agents.…”

A theoretical and practical critique of Social Facilitation Theory

“…El DSM-IV-TR (APA, 2000) cataloga la paruresis como Fobia social pero algunos acreditados investigadores discrepan de esta categorización porque la paruresis no cumple suficientes requisitos para ello; por ejemplo, Heimberg, Holt, Schneier, Spitzer & Liebowitz (1993) propusieron excluir la paruresis de esta clasificación diagnóstica, propuesta que Hammelstein & Soifer (2006) han retomado recientemente por la evidencia empírica acumulada: estos autores consideran que la paruresis es un desorden funcional de la micción (functional disorder of micturition), si bien admiten la posibilidad de la existencia de diferentes manifestaciones o expresiones de paruresis: algunas se asemejarían más a una fobia social y otras tendrían una naturaleza más urológica (2006, p. 309). En un trabajo anterior, Hammelstein et al (2005) indicaban que el miedo no es un ingrediente imprescindible y fundamental de la paruresis sino otro: la incapacidad para orinar. Otros investigadores la conciben como un desorden psicosomático, una fobia a la micción o una retención urinaria psicógena (Watson & Freeland, 2000, p. 155).…”

Reflections on Relevance: <i>Psychotherapy and Psychosomatics</i> in 2005

“…Hammelstein et al [28] focused on several issues regarding 'paruresis', or psychogenic urinary retention, a special subtype of social phobia which manifests in the inability to urinate in public restrooms, in a sample of 1,105 men. They demonstrated the validity and reliability of a self-report screening instrument for this condition.…”