What is the relationship between swallowing difficulties and underlying mental health issues?
Reviewed by Gemma Clunie

People living with dysphagia often experience mental health difficulties. This study aimed to identify whether pre-existing anxiety and depression impacted patient scores on a patient-reported swallowing outcome measure, the Eating Assessment Tool (EAT-10) where a score of ≥3 is indicative of perceived swallowing difficulty. Data from the medical records of 290 consecutive patients were retrospectively collected. This included EAT-10 score, laryngoscopic examination, instrumental assessment of swallowing and whether there was a pre-existing diagnosis of anxiety or depression. Patients were classified into two groups between those with anxiety/depression (n=145) and a control group without these diagnoses. The first group was then divided into three groups (anxiety only, depression only, anxiety and depression). Similarly, patients were subdivided into normal swallowing, oropharyngeal (OP), oesophageal or OP and oesophageal dysphagia. Statistical analysis was used to compare mean EAT-10 scores between the no anxiety/depression and the anxiety/depression group, stratified by their swallowing function. For patients with normal swallowing but pre-existing anxiety/depression, the mean EAT-10 score was higher (14.32±11.42) than those with normal swallowing but no pre-existing diagnosis of anxiety/depression (8.93±6.59). The study posits that people with pre-existing mental health diagnoses may experience worse symptoms of dysphagia despite normal swallowing on instrumental assessment, but that a similar relationship did not exist for people with instrumentally diagnosed dysphagia. They recommend that further prospective studies explore this disparity and its implications in more detail.

Correlations Between Anxiety and/or Depression Diagnoses and Dysphagia Severity.
Doruk C, Mocchetti V, Rives H, et al.
LARYNGOSCOPE
2024:134(5):2115–120.