title: A prospective psychological evaluation of patients with dysphagia of various etiologies.
abstract: We hypothesized that patients who complain of dysphagia without demonstrable organic abnormality may have an underlying psychological dysfunction. We thus conducted a comprehensive assessment in three groups of patients with dysphagia. Dysphagia was classified as obstructive (Obst) when an obstructive lesion was present on esophagoscopy or barium swallow, motility-related (Mot) when abnormal motility was shown on esophageal manometry in the presence of normal esophagoscopy or barium swallow, or nonobstructive, nonmotility-related (NONM) when manometry and esophagoscopy or barium swallow were both normal. We prospectively evaluated 71 patients with Obst-dysphagia, 15 patients with Mot-dysphagia and 10 patients with NONM-dysphagia with a battery of standardized psychological tests including the Minnesota Multiphasic Personality Inventory (MMPI), the Symptom Checklist-90-Revised (SCL-90-R), and the Millon Behavioral Health Inventory (MBHI). The results indicate that patients with NONM-dysphagia have psychological attributes similar to those found in patients with Obst-dysphagia or Mot-dysphagia. Combination of scores for parameters such as somatization, depression, and anxiety could not distinguish among the three groups of dysphagia patients. We thus conclude that patients with NONM-dysphagia, as a group, have similar psychological profiles compared to patients with dysphagia due to organic causes.
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Kim
authors.forename: J J
authors.initials: JJ
authors.lastname: Hsu
authors.forename: D E
authors.initials: DE
authors.lastname: Williams
authors.forename: A L
authors.initials: AL
authors.lastname: Weaver
authors.forename: A R
authors.initials: AR
authors.lastname: Zinsmeister
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis; D001466:Barium Sulfate; D003287:Contrast Media; D003680:Deglutition Disorders / Q000209:etiology* / Q000523:psychology*; D003863:Depression / Q000175:diagnosis; D004935:Esophageal Diseases / Q000150:complications / Q000175:diagnosis; D015154:Esophageal Motility Disorders / Q000150:complications / Q000175:diagnosis; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008950:MMPI; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010555:Personality Inventory; D011446:Prospective Studies; D011581:Psychological Tests; D013001:Somatoform Disorders / Q000175:diagnosis
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate