[Objective] We investigated the history of asphyxiation and the status of food intake and swallowing in schizophrenia patients in order to establish a screening method to determine the asphyxiation risk for schizophrenia patients.
[Subjects and Methods] We created a questionnaire to evaluate the status of food intake and swallowing in schizophrenia patients. Nurses assessed 98 schizophrenia patients undergoing inpatient treatment using the questionnaire. We surveyed the subjects’ history of asphyxiation from their medical records. Subjects were divided into two groups according to the presence or absence of a history of asphyxiation, and their answers compared. We used discriminant analysis to identify questions that contributed to the determination of a history of asphyxiation in schizophrenia patients, and produced a screening method to determine asphyxiation risk.
[Results] Four patients had a history of asphyxiation. Answers that were significantly more common in these patients were “possess false teeth,” “swallow food almost whole,” “have previously engaged in stealthy or secret eating,” and “swallowing improved.” The answer that was significantly less common in patients with a history of asphyxia was “delayed swallow response.” In discriminant analysis, when we allocated a score of ＋1 point for “swallow food almost whole,” of ＋1 point for “have previously engaged in stealthy or secret eating,” and of ＋2 points for “swallowing improved,” a total of ≥ 2 points indicated elevated risk of asphyxiation. The method had a discrimination rate of 92.9%, sensitivity of 100%, and specificity of 92.6%.
[Conclusion] Asphyxiation in schizophrenia was related to behavioral abnormalities concerning food intake behavior and meals, and there was a tendency for it to occur more easily in patients in whom swallowing had improved. The screening method proposed in this study may be of use in the risk management of patients with schizophrenia.
