The “Emotional” Phase of Swallowing Psychogenic Disorders The challenge to the speech-language pathologist during evaluation and treatment of persons with dysphagia is to recognize when a patient may have a psychogenic cause for the described swallowing difficulties. This becomes particularly difficult when the patient presents with multiple system symptoms. The speech-language pathologist and the physician have ... Article
Article  |   October 01, 1998
The “Emotional” Phase of Swallowing Psychogenic Disorders
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Article   |   October 01, 1998
The “Emotional” Phase of Swallowing Psychogenic Disorders
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), October 1998, Vol. 7, 11-12. doi:10.1044/sasd7.3.11
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), October 1998, Vol. 7, 11-12. doi:10.1044/sasd7.3.11
The challenge to the speech-language pathologist during evaluation and treatment of persons with dysphagia is to recognize when a patient may have a psychogenic cause for the described swallowing difficulties. This becomes particularly difficult when the patient presents with multiple system symptoms. The speech-language pathologist and the physician have the responsibility to rule out any possibility of an early organic disorder presenting as a dysphagia that may coexist with the psychogenic disorder.
The categories of psychological disorders where dysphagia symptoms are prevalent are the Somatoform Disorders:
  • Somatization Disorder— polysymptomatic disorder presenting as pain, gastrointestinal and pseudoneurological symptoms.

  • Conversion Disorder—unexplained symptoms or deficits affecting voluntary motor or sensory function that suggest a neurological or other general medical condition. The patient truly believes symptoms to be organic; occur as a result of a severe emotional event or conflict, (e.g., “I can't swallow that anymore.”)

  • Pain Disorder—with pain as the dominant symptom.

  • Hypochondriasis—preoccupation with the fear of having a serious disease based on the person's misinterpretation of bodily symptoms or functions; no loss of body function.

  • Body Dysmorphic Disorder —preoccupation with an imagined or exaggerated defect in physical appearance.

  • Malingering—symptoms are intentional to obtain a goal (e.g. monetary compensation) or to avoid an unpleasant activity (e.g., work or school).

  • Munchausen Syndrome (Factitious Disorder)—symptoms are intentionally produced and rarely produce neurological symptoms such as in a conversion disorder; may include self-induced harm or addiction to unnecessary testing or surgery.

    (American Psychiatric Association, 1994)

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