Psychiatric aspects of dysphagia

Abstract

Dysphagia with a psychiatric background is a rare condition, not so well understood, and presented with no structural or organic disease detectable. More research would therefore be of importance for more knowledge about this condition that in several cases affects the quality of life in a negative way. Fear of swallowing, avoidance of swallowing specific foods, fluids, or pills seem to be the most frequent symptoms in psychogenic dysphagia, and may result in malnutrition and weight loss. When psychogenic dysphagia is suspected a thorough swallowing evaluation is necessary, involving clinical as well as instrumental examinations. A multidisciplinary approach is required. Professionals from neurology, otolaryngology, speech-language pathology, radiology, and gastroenterology may be involved. The diagnosis of psychogenic dysphagia should, to avoid misdiagnosis, be reserved for patients with strong psychological symptoms and fear of swallowing. Most effective treatment of psychogenic dysphagia seems to be a combination of psychological treatment and dysphagia therapy. Anti-anxiety medications may in some cases be effective. A close collaboration between the dysphagia clinician and colleagues in psychology is necessary for an optimal management.