Dysphagia is a Common and Serious Problem for Adults with Mental Illness: A Systematic Review

Abstract

Adults with mental illness may experience a higher incidence of dysphagia and choking due to factors such as medication side effects and behavioural abnormalities. The aim of this study was to determine the frequency of dysphagia and the most effective interventions for this population. Studies published up to August 2010 were sought via a comprehensive electronic database search (CINAHL, PsycINFO, MEDLINE, PubMed, Cochrane, and Embase). Studies reporting dysphagia frequency or dysphagia intervention outcomes in adults with mental illness were included. Two reviewers independently assessed study eligibility and quality, and the results were synthesised descriptively. Ten studies were identified, each describing dysphagia frequency or death due to choking asphyxiation. No studies evaluating intervention effectiveness were identified. Study quality was limited by subjective assessment of outcomes. Six studies presented dysphagia frequencies ranging from 9 to 42% in varying subgroups. Four studies presented the frequency of choking asphyxiation death, including a large survey that concluded that adults with organic mental illness were 43 times more likely to die of this cause than the general population. Dysphagia is a common and significant cause of morbidity and mortality in adults with mental illness and our review found that there is a lack of studies evaluating the effectiveness of intervention techniques.

Effect of Rheological Properties on Sensory Acceptance of Two‐Model Dysphagia‐Oriented Food Products

“…). Aspiration, weight loss, malnutrition and anxiety are common consequences of dysphagia (Aldridge and Taylor ). Dysphagia is generally classified into two oropharyngeal and esophageal types.…”

A Case of Bipolar Affective Disorder and Aspiration Pneumonia

“…They speculated that the cause may be hyperverbosity. A recent systematic review of 10 studies revealed that the frequency of dysphagia in adults with mental illness was 9 to 46%, compared to 6% in the general population [3]. Causes may be multifactorial, including behavioural and pharmacological.…”

“…Our patient appears to have had recurrent aspiration pneumonia in association with manic episodes. There is no current guidance on interventions in managing dysphagia in adults with mental health illness [3]. …”

Mental health role statement: The role of dietitians in mental health and the role of a statement

“…A role statement also assists in establishing professional boundaries, which is useful when advocating for and explaining the role of APDs to other health professionals. In the case of mental health, for example, higher rates of dysphagia have been reported: 12,13 assessing swallowing difficulties is a speech pathologist's (SP's) role, while APDs have a role to work with SPs in managing any necessary diet prescriptions. It should be pointed out that a role statement is not designed to be a set of practice guidelines, entry-level standards or training recommendations for dietitians working in mental health.…”