The incidence of dysphagia in the population with mental health disorders may be higher as a result of a number of factors including the nature of the psychiatric disorder, effects of psychiatric medications, co-occurring neurologic conditions, and institutionalization and behavioral changes associated with the mental illness. This study aimed to determine the prevalence of dysphagia among adults with mental health disorders (MHDs) who attend acute and community mental health settings. Sixty attenders at a local area psychiatric service were assessed using a simple swallowing screening test. Subjects presented with a variety of mental health disorders and were attending an acute inpatient unit, day hospital, or long-term care setting. Thirty-two percent of those assessed demonstrated overt signs of oropharyngeal dysphagia. There was an increased prevalence in the inpatient unit (35%); the lowest prevalence of dysphagia was in those attending the day hospitals (27%). Thirty-one percent of those attending long-term care settings also had dysphagic symptoms. Twenty-three percent of individuals with schizophrenia in the total group had oropharyngeal dysphagia; this figure rose to 31% in the inpatient unit. Twenty-seven percent of individuals with bipolar affective disorder (BPAD) demonstrated overt signs of oropharyngeal dysphagia. Each of these individuals with BPAD was in an inpatient setting. The results of this study provide evidence to suggest that there is an increased incidence of dysphagia in those with mental health disorders. Of particular interest is the marked proportion (approximately one third) of those attending acute and long-term care settings with dysphagia. Possible contributing factors are discussed.
Objectives: To examine a sample of adults with mental health disorders attending at an area psychiatric service, for the presence of impairments in language, communication and swallowing, using a test battery administered by speech and language therapists.Method: The study surveyed a randomly selected sample (n = 60) of patients from an acute psychiatric inpatient unit and associated community services, using several standardised measures of language, communication and swallowing.Results: On this test battery, over 80% (50/60) of subjects studied demonstrated impairment in language; while over 60% (37/60) presented with impairment in communication and discourse. Over 30% (18/58) of subjects assessed showed some impairment in swallowing.Conclusion: Use of this test battery confirmed the presence of language, communication and swallowing impairments in many patients in this sample of attenders at a general psychiatry service. We suggest that this study provides evidence for a (currently unmet) need for specialist speech and language therapy assessment and support among this patient population.
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