Dysphagia and Chronic Mental Illness: Looking Beyond Hysteria and Broadening the Psychiatric Differential Diagnosis

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Sir: Over the past 30 years, the deinstitutionalization of individuals with severe and persistent mental illness has led primary care clinicians and psychiatrists to collaborate in the long-term medical management of these individuals. No longer is treatment confined to institutions and staff working there community-based physicians have assumed primary responsibility for the care of individuals with serious mental illness. This care includes treatment of complications due to long-term exposure to antipsychotic medications as well as treatment of illnesses that, having long been present in the general population, are now increasingly comorbid with serious mental illness in the community.