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Dysphagia

, Volume 6, Issue 1, pp 2–5 | Cite as

Dysphagia in psychiatric patients: Clinical and videofluoroscopic study

  • Patricia H. Bazemore
  • Joseph Tonkonogy
  • Rajoo Ananth
Article

Abstract

Deaths due to airway obstruction are more common in psychiatric inpatients than in the normal population. A dysphagia program was started in a 400 bed Massachusetts psychiatric hospital after 4 patients in 1 year died from asphyxia. In the year after the program was started, there were no deaths; however, 28 patients experienced 32 choking incidents. The 28 patients received clinical evaluations by speech pathologists, neurologists, psychiatrists, and internists. Of the incidents, 55% required use of the Heimlich maneuver to open the airway. Choking incidents could be classified into five types based on results of clinical examination: bradykinetic, dyskinetic, fast eating syndrome, paralytic, and medical.

Twenty-one of the 28 patients were studied by videofluoroscopy and 86% of the videos were abnormal, showing aspiration in eight, webs in five, and delay in the oral phase in five. Patients with bradykinetic dysphagia (secondary to neuroleptic-induced extra-pyramidal syndrome [EPS]) and paralytic dysphagia appeared to experience a more severe from of choking.

Key words

Neuroleptics Psychiatric inpatients Airway obstruction Movement disorders Deglutition Deglutition, disorders 

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Copyright information

© Springer-Verlag New York Inc 1991

Authors and Affiliations

  • Patricia H. Bazemore
    • 1
    • 2
  • Joseph Tonkonogy
    • 1
  • Rajoo Ananth
    • 2
  1. 1.University of Massachusetts Medical CenterWorcesterUSA
  2. 2.Worcester State HospitalWorcesterUSA

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