Prevalence of Dysphagia in Acute and Community Mental Health Settings

Abstract

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.

Bedside assessment of swallowing in elderly subjects using psychotropic drugs

“…study and other published papers are due both to the methods for evaluating swallowing and to observing carefully the relationship between food consistency and clinical signs [5][6][7][8][9][10][11]19,21,[23][24][25] . Therefore, while one of those studies found changes in 30% of subjects, and another found changes in 90% of subjects, we encountered no significant effect of neuroleptic drugs on swallowing 7,11 . As other factors and co-morbidities may cause dysphagia, even in youths, previous reports may have attributed swallowing effects to neuroleptic drugs without first applying appropriate verification methods.…”

Evaluation of oral antidepressant drugs for adaptation to the simple suspension method

“…1 Depression is the most common among these diseases, 2,3 and since mental illness reduces activity in addition to affecting an individual's emotional state, it can lead to diffi culty swallowing in some patients. 4,5 In such cases, it is necessary to administer medicine or nutrition via gavage administration through a gastric or intestinal stoma at the surface of the abdomen, or via a transnasal tube. Recently, the simple suspension method has garnered attention for its effectiveness and for the increased drug stability and safety associated with its use.…”

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

“…The prevalence of dysphagia is thought to vary according to aetiology and the age of the individual [2]. While dysphagia has been reported to occur in 6% of the general population [4], it is thought to be a more common problem in the population of adults with mental illness [5,6]. Mental disorder or illness is defined as comprising a broad range of problems with different symptoms, generally characterised by some combination of abnormal thoughts, emotions, behaviour, and relationships with others [7].…”

“…Some examples are schizophrenia, depression, mental retardation, and disorders due to drug abuse [7]. Possible causes of dysphagia in the population of adults with mental illness include side effects of psychiatric medications, including neuroleptics [5,6,8], behavioural changes associated with the psychiatric disorder itself, concurrent neurological disorders, and the effects of institutionalisation [5,6].…”