Pre-Existing Anxiety/Depression May Aggravate Dysphagia in Patients with Normal Swallowing Function

by Linda Kossoff •

CLINICAL QUESTION

What is the effect of a pre-existing diagnosis of anxiety and/or depression (anxiety/depression on Eating Assessment Tool (EAT-10) measures) in patients with dysphagia?

BOTTOM LINE

Although anxiety/depression may aggravate dysphagia in patients with normal swallowing function, this correlation may not hold in those with objective swallowing dysfunction.

BACKGROUND: Depression and anxiety are common mental health disorders that often co-occur with other chronic health conditions. People with dysphagia often report associated anxiety and affective symptoms, notably through the social disruption aspect of meal sharing. However, the effects of pre-existing anxiety/depression on swallowing function surveys have not been investigated.

STUDY DESIGN: Retrospective chart review.

SETTING: Weill Cornell Medicine, Department of Otolaryngology-Head & Neck Surgery, Sean Parker Institute for the Voice, New York, N.Y.

SYNOPSIS: Researchers investigated patients evaluated for dysphagia in a laryngology clinic from January 2018 to October 2022. Patients’ charts were reviewed for history of anxiety or depression. Included subjects had completed the EAT-10 questionnaire. A total of 290 patients (55.0% female, average age 66.0 years) met inclusion criteria. Among these patients, 60 had anxiety, 49 had depression, and 36 had both. The subjects were classified into Group 1, the anxiety/depression group, and Group 2, the control group, with no anxiety or depression. Within Groups 1 and 2, 115 and 116 patients, respectively, had abnormal swallowing. Researchers compared mean EAT-10 scores between the anxiety/depression and no anxiety/depression groups, stratified by swallowing dysfunction etiology. They found that in patients with normal swallowing function on instrumental examination, dysphagia symptoms were amplified in the presence of anxiety/depression. Anxiety/depression did not aggravate dysphagia in patients with objective findings of swallowing dysfunction. As in previous studies, there was a high prevalence of anxiety/depression presenting with dysphagia. The authors note that, given an aging population and the likelihood of increased dysphagia incidence, gaining insight into mood and anxiety comorbidities in these patients will be important. Study limitations included its retrospective nature.

CITATION: Doruk C, Mocchetti V, Rives H, et al. Correlations between anxiety and/or depression diagnoses and dysphagia severity. Laryngoscope. 2024;134:2115–2120.