Oesophageal motility disorders in patients with psychiatric disease

Abstract

Clinical and experimental observations indicate that the motility of the oesophagus may be affected by emotional stimuli. The aim of this study was to evaluate the incidence of oesophageal contractility impairment in patients suffering from a psychiatric disorder. Fifty-one patients admitted to the psychiatric department were submitted to an oesophageal transit study by means of krypton-81m. All patients with an abnormal oesophageal transit underwent manometry and endoscopy. The level of depression and anxiety was evaluated by the treating psychiatrist, using the Hamilton Depression and Anxiety Rating Scales. The oesophageal transit was abnormal in 13 patients. Two of these 13 patients refused manometric investigation. In ten of the 11 remaining patients, the manometry revealed functional motor abnormalities. Endoscopy, performed in all these ten patients, was normal. In conclusion, a high percentage of oesophageal contractility disturbances was found in psychiatric patients complaining of anxiety and/or depression. These abnormalities were detected by scintigraphy as well as by manometry. Owing to the normal endoscopic findings, these contraction abnormalities are likely to reflect a functional motor impairment.

Medically Unexplained Oropharyngeal Dysphagia at the University Hospital ENT Outpatient Clinic for Dysphagia: A Cross-Sectional Cohort Study

“…However, an interesting question is whether MUNOD could disturb normal swallowing physiology. Roland et al evaluated the incidence of esophageal contractility disturbances in psychiatric patients [27]. Manometry showed a high percentage of functional motor impairment in patients with complaints of anxiety and/or depression, while endoscopy in these patients showed no structural abnormalities [27].…”

“…Roland et al evaluated the incidence of esophageal contractility disturbances in psychiatric patients [27]. Manometry showed a high percentage of functional motor impairment in patients with complaints of anxiety and/or depression, while endoscopy in these patients showed no structural abnormalities [27]. In a large prospective population-based study, Koloski et al showed that anxiety is an independent predictor for new onset functional gastrointestinal disorders like irritable bowel syndrome, suggesting that affective disorders can underlie physical symptoms [28].…”

Mental Health and Quality of Life among Egyptian Patients with Esophageal Motility Disorders: A Psychiatric Assessment

“…Manometry was performed on those with abnormal results, but two patients refused. The result was that 10 of the 11 tested patients had major motor abnormalities by manometry, indicating a relationship between psychiatric problems and motor disorders [23].…”

“…Kim, Chung H., et al's (1996) study found that depression and anxiety were not different among patients with dysphagia due to outflow obstruction, peristalsis disorders, and those without findings in endoscopy, barium or manometry. Roland et al (1996) evaluated 51 patients with psychiatric problems and upper GI somatization symptoms by esophageal transit time, 13 of whom had abnormal or delayed transit time. Manometry was performed on those with abnormal results, but two patients refused.…”

Dysphagia in a psychotic patient: Diagnostic challenges and a systematic management approach

“…[4] It is possible that dysphagia can be part of a psychotic experience, namely a delusion of control or somatic passivity phenomenon. [5] There have also been a few reports that dysphagia/esophagial motility disorders are likely to be “inherent” in psychiatric disorders,[67] more so in Schizophrenia. [8] It is also a well-known fact that the prevalence of medical co-morbidity is significantly higher in mentally ill patients and hence an organic cause for dysphagia can never be ignored.…”