Anxiety and depression in patients with post-surgical dysphagia in Sri Lanka

Background: Undiagnosed anxiety and depression are obstacles for the effective treatment of post-surgical dysphagia. The prevalence and associations between postsurgical dysphagia and anxiety and depression are poorly studied areas in Sri Lanka. 

Aims: This study aimed to determine the proportion of anxiety and depression among patients with dysphagia following oral, oral maxillofacial (OMF), and neck surgeries, and to identify the associations between the severity and stage of dysphagia, and the occurrence of anxiety and depression.

Methods: A cross-sectional study was conducted among 95 participants with post-operative dysphagia following oral, OMF and neck surgeries, at four tertiary care hospitals. The Hospital Anxiety and Depression Scale, oral-motor and cranial nerve examination, the 3ml water swallow test, cervical auscultation and the Dysphagia Severity Rating Scale were used for data collection.

Results: The majority of the participants (52%) presented with dysphagia in the pharyngeal phase, and 51% presented with severe dysphagia. Among the participants, 52% screened positive for depression and 39% for anxiety, while 37% and 47% showed borderline levels of depression and anxiety respectively. There was a statistically significant association between increasing severity of dysphagia and increasing levels of anxiety.

Conclusions: This study reflects that there is a high psychological burden among patients with dysphagia following oral, OMF, and neck surgeries. This highlights the need for the incorporation of interdisciplinary treatment strategies, as undiagnosed anxiety and depression are likely to impact negatively on the rehabilitation and management of patients with dysphagia.