Symptoms of anxiety and depression assessed with the Hospital Anxiety and Depression Scale in patients with oropharyngeal dysphagia

Objective: The aim of the present study is to determine the presence and severity of symptoms of anxiety and depression in patients with oropharyngeal dysphagia who visit the outpatient clinic for dysphagia. Methods: Symptoms of anxiety and depression (affective symptoms) were prospectively assessed in 96 patients using the validated Hospital Anxiety and Depression Scale. In addition, all patients underwent a standardized examination protocol used for regular healthcare in the outpatient setting for dysphagia. The protocol included the following: otorhinolaryngological examination, logopedic observation of oral intake, fiber optic endoscopic evaluation of swallowing, videofluoroscopy of swallowing, the Functional Oral Intake Scale, a dysphagia severity scale, and the M.D. Anderson Dysphagia Inventory. Depending on the presence/absence of symptoms of anxiety and depression, several groups were distinguished. Descriptive statistics and the Mann-Whitney U test were used to test for group differences. Logistic regression models were used to identify factors associated with symptoms of anxiety and/or depression (cut-off score >8). Results: Clinically relevant symptoms of anxiety were observed in 37% (N = 34) and clinically relevant symptoms of depression in 32.6% (N = 31) of the present patient population, with 21.3% having symptoms of both anxiety and depression. In total, 47.3% (N = 43) of this population showed affective symptoms. Conclusion: Given that psychological burden can enhance somatic complaints, the high number of patients suffering from affective symptoms is a relevant clinical outcome in dysphagic patients. The contribution of anxiety or depression to the development or worsening of oropharyngeal dysphagia and their role in interdisciplinary treatment strategy is warranting further research. (C) 2013 Elsevier Inc. All rights reserved.