Epidemiology and associated factors of screening-identified dysphagia risk in psychiatric inpatients

doi:10.5498/wjp.118764

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World Journal of Psychiatry

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2220-3206

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Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Aug 19, 2026; 16(8): 118764
Published online Aug 19, 2026. doi: 10.5498/wjp.118764

Table 1 Clinical and demographic characteristics of the low-risk group and moderate-to-severe risk group, n (%)

Characteristics	Low-risk group (n = 2357)	Moderate-to-severe risk group (n = 57)	Z/χ²	P value
Sex			0.06	0.812
Male	905 (38.4)	21 (36.8)
Female	1452 (61.6)	36 (63.2)
Age (year), mean ± SD	42.38 ± 18.40	58.81 ± 21.66	-5.56	< 0.001^a
Age group (years)			34.37	< 0.001^a
0-17	239 (10.1)	2 (3.5)
18-44	1072 (45.5)	12 (21.1)
45-59	612 (26.0)	16 (28.1)
≥ 60	434 (18.4)	27 (47.4)
Marital status			12.24	0.007^a
Unmarried	658 (27.9)	10 (17.5)
Married	1588 (67.4)	43 (75.4)
Divorced	87 (3.7)	1 (1.8)
Widowed	24 (1.0)	3 (5.3)
Occupation			15.61	0.008^a
Student	324 (13.7)	2 (3.5)
Worker	63 (2.7)	2 (3.5)
Farmer	321 (13.6)	10 (17.5)
Employee	216 (9.2)	10 (17.5)
Unemployed person	1337 (56.7)	27 (47.4)
Retiree	96 (4.1)	6 (10.5)
Education			9.65	0.047^a
Illiteracy	332 (14.1)	16 (28.1)
Elementary school	529 (22.4)	12 (21.1)
Junior high school	808 (34.3)	18 (31.6)
Senior high school	410 (17.4)	7 (12.3)
University	278 (11.8)	4 (7.0)
BMI (kg/m²)	24.49 ± 6.08	24.50 ± 3.51	-0.33	0.745
Length of hospital stay (days), mean ± SD	59.81 ± 85.55	98.12 ± 220.49	-1.10	0.271
Duration of illness (months), mean ± SD	109.92 ± 125.85	138.22 ± 143.62	-0.96	0.337
Number of episodes, mean ± SD	2.64 ± 2.11	3.05 ± 2.52	-1.35	0.177
Diagnosis			10.02	0.187
Depression	523 (22.2)	17 (29.8)
Schizophrenia	529 (22.4)	18 (31.6)
Bipolar disorder	519 (22.0)	11 (19.3)
Intellectual disabilities	124 (5.3)	3 (5.3)
Dissociative disorders	161 (6.8)	3 (5.3)
Anxiety disorders	51 (2.2)	2 (3.5)
Mental and behavioral disorders due to use of alcohol	286 (12.1)	2 (3.5)
Other mental disorders	164 (7.0)	1 (2.2)
Medication
Antipsychotics	1827 (77.5)	47 (82.5)	0.78	0.376
Antidepressants	936 (39.7)	22 (38.6)	0.29	0.865
Anxiolytics	280 (11.9)	11 (19.3)	2.89	0.089
Mood stabilizers	937 (39.8)	16 (28.1)	3.18	0.075
Antiepileptic drugs	509 (21.6)	12 (21.1)	0.01	0.922
Benzodiazepines	862 (36.6)	22 (38.6)	0.10	0.754
Somatic comorbidity
Hypertension	341 (14.5)	13 (22.8)	3.08	0.079
Coronary heart disease	181 (7.7)	14 (24.6)	21.33	< 0.001^a
Myocardial ischemia	379 (16.1)	11 (19.3)	0.43	0.514
Inflammatory indicators, mean ± SD
NLR	2.32 ± 1.84	2.08 ± 1.20	-1.01	0.311
PLR	145.85 ± 85.11	135.06 ± 60.83	-0.91	0.365
MLR	0.27 ± 0.20	0.24 ± 0.12	-0.70	0.483
NMR	9.84 ± 6.20	9.85 ± 5.34	-0.06	0.949
SII	522.48 ± 490.67	474.87 ± 299.28	-1.24	0.215
Thyroid function, mean ± SD
T3	1.58 ± 0.40	1.54 ± 0.31	-0.75	0.457
T4	96.18 ± 28.53	104.00 ± 28.22	-2.09	0.036^a
FT4	16.12 ± 3.96	16.46 ± 3.34	-1.42	0.156
FT3	4.78 ± 1.06	4.56 ± 0.63	-1.56	0.118
TSH	2.54 ± 3.05	6.80 ± 22.04	-1.06	0.291

^aP < 0.05.

BMI: Body mass index; PLR: Platelet-lymphocyte ratio; NLR: Neutrophil-lymphocyte ratio; NMR: Neutrophil-monocyte ratio; MLR: Monocyte-lymphocyte ratio; SII: Systemic immune-inflammation index; T3: Triiodothyronine; T4: Thyroxine; FT4: Free thyroxine; FT3: Free triiodothyronine; TSH: Thyroid stimulating hormone.

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Table 2 Univariate logistic regression analysis of variables associated with moderate-to-severe dysphagia risk

Characteristics	β	SE	OR	95%CI	P value
Sex	0.066	0.278	1.068	0.620-1.842	0.812
Age	0.047	0.008	1.048	1.033-1.064	< 0.001^a
Age groups
0-17	-	-	-	1.00	-
18-44	0.291	0.767	1.338	0.297-6.016	0.704
45-59	1.139	0.754	3.124	0.713-13.691	0.131
≥ 60	2.006	0.737	7.434	1.753-31.534	0.007^a
Marital status
Unmarried	-	-	-	1.00	-
Married	0.578	0.354	1.782	0.890-3.567	0.103
Divorced	-0.279	1.055	0.756	0.090-5.980	0.791
Widowed	2.107	0.690	8.225	2.126-31.822	0.002^a
Occupation
Student	-	-	-	1.00	-
Worker	1.638	1.009	5.143	0.711-37.191	0.105
Farmer	1.619	0.779	5.047	1.097-23.214	0.038^a
Employ	2.015	0.780	7.500	1.627-34.564	0.010^a
Unemployed person	1.185	0.735	3.272	0.774-13.828	0.107
Retiree	2.315	0.825	10.125	2.011-50.980	0.005^a
Education
Illiteracy	-	-	-	1.00	-
Elementary school	-0.754	0.388	0.471	0.220-1.007	0.052
Junior high school	-0.772	0.350	0.462	0.233-0.917	0.027^a
Senior high school	-1.038	0.459	0.354	0.144-0.871	0.024^a
University	-1.209	0.565	0.299	0.099-0.903	0.032^a
BMI	< 0.001	0.022	1.000	0.958-1.044	0.989
Length of hospital stay	0.002	0.001	1.002	1.001-1.003	0.005^a
Disease duration	0.002	0.001	1.002	1.000-1.003	0.096
Number of episodes	0.073	0.050	1.075	0.975-1.186	0.144
Diagnosis
Mental and behavioral disorders due to use of alcohol	-	-	-	1.00	-
Depression	1.536	0.751	4.648	1.066-20.261	0.041^a
Schizophrenia	1.582	0.749	4.866	1.121-21.119	0.035^a
Bipolar disorder	1.109	0.772	3.031	0.667-13.768	0.151
Intellectual disabilities	1.241	0.919	3.460	0.571-20.963	0.177
Dissociative disorders	0.980	0.918	2.665	0.441-16.113	0.286
Anxiety disorders	1.724	1.011	5.608	0.772-40.717	0.088
Other mental disorders	-0.137	1.229	0.872	0.078-9.690	0.911
Medication
Antipsychotics	0.310	0.352	1.363	0.684-2.717	0.378
Antidepressants	-0.047	0.275	0.954	0.556-1.637	0.865
Anxiolytics	0.573	0.342	1.774	0.908-3.465	0.093
Mood stabilizers	-0.525	0.298	0.591	0.330-1.060	0.078
Antiepileptic drugs	-0.032	0.329	0.968	0.508-1.844	0.922
Benzodiazepines	0.086	0.275	1.090	0.635-1.870	0.754
Somatic comorbidity
Hypertension	0.557	0.321	1.745	0.930-3.274	0.083
Coronary heart disease	1.364	0.317	3.911	2.100-7.283	< 0.001^a
Myocardial ischemia	0.222	0.340	1.248	0.641-2.431	0.515
Inflammatory indicators
NLR	-0.105	0.102	0.900	0.737-1.100	0.900
PLR	-0.002	0.002	0.998	0.994-1.002	0.337
MLR	-1.105	0.984	0.331	0.048-2.276	0.261
NMR	< 0.001	0.022	1.000	0.959-1.044	0.987
SII	-0.001	< 0.001	0.999	0.999-1.000	0.214
Thyroid function
T3	-0.288	0.365	0.750	0.367-1.532	0.429
T4	0.008	0.004	1.008	1.000-1.016	0.039^a
FT4	0.019	0.030	1.020	0.961-1.082	0.522
FT3	-0.300	0.176	0.741	0.525-1.045	0.087
TSH	0.042	0.012	1.043	1.019-1.068	< 0.001^a

^aP < 0.05.

Full Size Table

Table 3 Multivariate logistic regression analysis of variables associated with moderate-to-severe dysphagia risk

Characteristics	β	SE	OR	95%CI	P value
Age	0.076	0.012	1.079	1.055-1.104	< 0.001^a
Marital status
Unmarried	-	-	-	1.00	-
Married	-1.389	0.490	0.259	0.095-0.652	0.005^a
Divorced	-1.749	1.104	0.174	0.020-1.516	0.113
Widowed	-1.728	0.955	0.178	0.027-1.156	0.071
Length of hospital stay	0.002	0.001	1.002	1.000-1.003	0.030
Diagnosis
Mental and behavioral disorders due to use of alcohol	-	-	-	1.00	-
Depression	0.964	0.785	2.622	0.563-12.206	0.219
Schizophrenia	1.714	0.776	5.550	1.214-25.384	0.027^a
Bipolar disorder	1.308	0.793	3.700	0.783-17.493	0.099
Intellectual disabilities	2.119	0.968	8.319	1.247-55.477	0.029^a
Dissociative disorders	0.699	0.950	2.012	0.313-12.943	0.462
Anxiety disorders	-0.048	1.195	0.953	0.091-9.920	0.968
Other mental disorders	-0.717	1.262	0.488	0.041-5.791	0.570
Thyroid function
TSH	0.053	0.02	1.054	1.013-1.097	0.009^a

^aP < 0.05.

The bold values indicate statistically significant associations (P < 0.05). OR: Odds ratio; CI: Confidence interval; TSH: Thyroid stimulating hormone.

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Table 4 Receiver operating characteristic analysis of variables associated with moderate-to-severe dysphagia risk

Indicator	Optimal cut-off value	Sensitivity (%)	Specificity (%)	AUC	95%CI	P value
Age	49.50	70.2	62.9	0.715	0.641-0.789	< 0.001^a
Length of hospital stay	33.50	57.5	57.9	0.543	0.460-0.625	0.310
Thyroid function
TSH	1.47	77.2	33.1	0.541	0.465-0.617	0.291

^aP < 0.05.

Area under the curve values closer to 0.5 indicate limited discriminative ability. AUC: Area under the curve; CI: Confidence interval; TSH: Thyroid stimulating hormone.

Full Size Table

Citation: Liu ZQ, Feng YQ, Fu CY, Wang JH, Zhang KX, Yuan XC, Li R, Zhang CC, Huang GH, Zhang YB, Li K. Epidemiology and associated factors of screening-identified dysphagia risk in psychiatric inpatients. World J Psychiatry 2026; 16(8): 118764
URL: https://www.wjgnet.com/2220-3206/full/v16/i8/118764.htm
DOI: https://dx.doi.org/10.5498/wjp.118764

Liu ZQ, Feng YQ, Fu CY, Wang JH, Zhang KX, Yuan XC, Li R, Zhang CC, Huang GH, Zhang YB, Li K. Epidemiology and associated factors of screening-identified dysphagia risk in psychiatric inpatients. World J Psychiatry 2026; 16(8): 118764 [DOI: 10.5498/wjp.118764]

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