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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV1167

Addressing dysphagia in psychiatric populations: a proposed three-stage framework for systematic screening, risk identification, and individualized intervention

ADDRESSING DYSPHAGIA IN PSYCHIATRIC POPULATIONS: A PROPOSED THREE-STAGE FRAMEWORK FOR SYSTEMATIC SCREENING, RISK IDENTIFICATION, AND INDIVIDUALIZED INTERVENTION

A three-stage framework integrating screening, risk stratification, and individualized intervention is proposed for dysphagia, which is highly prevalent among psychiatric patients.

The aim of this presentation is to propose a three-stage screening and management framework tailored to psychiatric settings for dysphagia (difficulty swallowing), a neglected but clinically significant complication in people with mental disorders. Stage I involves the planned development of a screening tool. In Phase A, a 20-member panel representing 5 disciplines will use a 3-round Delphi consensus process to develop 61 items across 5 domains, with an item-level content validity index (I-CVI) of at least 0.78. In Phase B, MASA will be used as the gold standard in at least 80 inpatients, a videofluoroscopic swallowing study (VFSS) will be performed in a subsample, and a cutoff will be established with a target ROC/AUC of at least 0.80. Stage II involves examining the associations of medication, comorbidity, and behavioral factors obtained from medical records with MASA/VFSS-confirmed dysphagia. Stage III comprises an individualized intervention combining swallowing therapy (postural adjustments, consistency modification, stimulation) with medication optimization. According to the synthesized evidence, dysphagia prevalence is 6% in the general population, compared with 23% in schizophrenia, 27% in bipolar disorder, and 35% among inpatients; the poster's background section reports a range of 23–30% for people with mental disorders. Among the five quantified risk domains, medication-related effects are the most prominent at 57%, followed by neurological comorbidity (20%), behavioral/cognitive factors (15%), age-related factors and frailty (15%), and nutrition and oral health (12%). VFSS findings were abnormal in 86% of psychiatric patients who had experienced a choking episode. Mechanistically, first-generation antipsychotics act through motor impairment (extrapyramidal symptoms, EPS), whereas second-generation agents act through sensory and functional impairments (sedation, dry mouth). The authors emphasize the urgent need for a structured, psychiatry-specific framework to shift from reactive management to predictive risk stratification and state that findings from Stages I and II will directly inform Stage III interventions.

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