Verdonschot Rob J C G, Baijens Laura W J, Vanbelle Sophie, van de Kolk Ilona, Kremer Bernd, Leue Carsten
Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; Emergency Department, Erasmus Medical Center, Rotterdam, The Netherlands.
Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
J Psychosom Res. 2017 Jun;97:102-110. doi: 10.1016/j.jpsychores.2017.04.006. Epub 2017 Apr 20.
Affective disorders are prevalent in different somatic conditions and influence somatic symptom bother and quality of life. Mood and anxiety disorders impact patients' compliance and adherence to treatment. This systematic review summarizes published studies on affective complaints in patients with oropharyngeal dysphagia (OD) in order to determine the quality of studies concerning any association of OD with symptoms of depression and/or anxiety.
A literature search was carried out using electronic databases Embase, Medline, Web-of-science, PsycINFO, Cochrane Library, and Google scholar. Two reviewers made the preselecting cut by screening all articles on title and abstract and independently screened the full texts of this initial set of articles. Methodological quality of the studies that met the inclusion criteria was assessed independently.
Twenty-six articles were included in the analysis after full-text screening and by applying the inclusion and exclusion criteria. All studies concluded that symptoms of depression were associated with impaired swallowing function, and 9 out of 12 studies concluded that symptoms of anxiety were associated with functional impairment of swallowing. The reviewers found heterogeneous outcomes and methodological limitations, which prevented data from pooling.
Although no meta-analytic conclusions can be drawn, it appears that symptoms of anxiety and depression are common in OD. Caregivers have to be aware of this in order to detect affective comorbidity. Given that affective conditions influence patients' treatment adherence and compliance, integrated care approaches should be advocated in case of comorbidity. Studies on treatment effect are lacking and well-designed prospective research is needed.
情感障碍在不同躯体疾病中普遍存在，并影响躯体症状困扰和生活质量。情绪和焦虑障碍会影响患者对治疗的依从性。本系统评价总结了关于口咽吞咽困难（OD）患者情感障碍的已发表研究，以确定有关OD与抑郁和/或焦虑症状之间关联的研究质量。
使用电子数据库Embase、Medline、科学网、PsycINFO、Cochrane图书馆和谷歌学术进行文献检索。两名评审员通过筛选所有文章的标题和摘要进行预选，并独立筛选这组初始文章的全文。对符合纳入标准的研究的方法学质量进行独立评估。
在全文筛选并应用纳入和排除标准后，26篇文章被纳入分析。所有研究均得出结论，抑郁症状与吞咽功能受损有关，12项研究中有9项得出结论，焦虑症状与吞咽功能障碍有关。评审员发现结果存在异质性且方法学存在局限性，这使得无法汇总数据。
虽然无法得出荟萃分析结论，但焦虑和抑郁症状在OD中似乎很常见。护理人员必须意识到这一点，以便发现情感共病。鉴于情感状况会影响患者的治疗依从性，合并症患者应提倡综合护理方法。缺乏关于治疗效果的研究，需要设计良好的前瞻性研究。
