Over a six-month period 50 patients referred for clinical esophageal manometry were independently evaluated for psychiatric diagnoses to determine whether there was any association between psychiatric illness and esophageal motility disorders. The manometric studies were blindly classified according to findings in the esophageal body. Twenty-five patients were classified as having one or more of the following contraction abnormalities: an increase in mean wave amplitude, an increase in mean wave duration, an increased frequency of abnormal motor responses, or the presence of triple-peaked waves. Psychiatric diagnoses were made in 21 (84 per cent) of the 25 patients but in only 4 (31 per cent) of the 13 patients with normal manometric patterns (P<0.005) and 4 (33 per cent) of the 12 with other manometric abnormalities (P<0.01). The fact that psychiatric illness is associated with a specific cluster of esophageal contraction abnormalities may provide a basis for further investigation of the relation between emotional disturbances and disorders of gastrointestinal motility. (N Engl J Med 1983; 309:1337–42.).