Medically Unexplained Oropharyngeal Dysphagia at the University Hospital ENT Outpatient Clinic for Dysphagia: A Cross-Sectional Cohort Study.

Only 14 patients were included, and the paper says the population was too small for further statistical analyses. The study was cross-sectional and was not intended as a therapy-effect study, so it cannot show that anxiety or depression caused the dysphagia or that psychiatric treatment improves swallowing. Anxiety and depression were measured with one screening questionnaire, the HADS, rather than a psychiatric diagnosis, and different screening tools might have produced different results. Three participants were taking psychiatric medication, which could affect swallowing and could also have lowered HADS scores. The paper says 14 patients were included and reports 14 participants in the anxiety, depression, and swallowing severity analyses, but it also says one patient with deeper penetration was excluded because a somatic cause could not be excluded. All patients were required to know Dutch and were seen in one university hospital ENT dysphagia clinic, so the findings may not apply elsewhere. FEES showed no aspiration or pyriform sinus pooling, but piecemeal deglutition was common, so swallowing physiology was not simply normal.

Do not read this as proof that anxiety or depression caused the swallowing complaints, or that treating them will improve swallowing. The study had only 14 patients, was cross-sectional, and did not test treatment. Also, FEES was not entirely normal because piecemeal deglutition was common, so a normal structural finding does not mean swallowing physiology is normal.