Correlation Between a Diagnosis of Anxiety or Depression and Initial VHI‐10 Scores in Benign Dysphonia

Abstract

Objective Anxiety and depression have demonstrated a positive correlation with vocal handicap among patients with benign causes of dysphonia. Our objective is to explore differences in initial Vocal Handicap Index–10 (VHI-10) scores between patients with a mental health history of anxiety or depression and those without. Study Design Retrospective cohort study. Setting Demographic data, diagnoses, and initial VHI-10 scores were collected for patients presenting with dysphonia to 2 tertiary laryngology clinics. Methods A Kruskal-Wallis test and subsequent Mann-Whitney U test for pairwise comparisons were used to compare distribution of VHI-10 scores among patients with anxiety, depression, anxiety and depression, and no such conditions. Bonferroni correction was used to control for multiple comparisons. Robust regression was used for multivariable analysis. Results A total of 620 cases of benign dysphonia were analyzed. Forty-two percent of the patient cohort had a preexisting diagnosis of anxiety (n = 121, 20%), depression (n = 64, 10%), or anxiety and depression (n = 74, 12%). VHI-10 scores were higher in patients with depression than in those without anxiety or depression (median difference, 4 [95% CI, 1-8]; P = .005) but did not differ significantly among the other groups. The effects of depression and anxiety status on initial VHI-10 scores among the causes of benign dysphonia varied. Conclusions Patients with a history of depression who presented with dysphonia had worse vocal handicap than those without anxiety/depression history. Future studies may clarify how optimization of anxiety and depression can affect patient-reported vocal handicap.

Correlations Between Anxiety and/or Depression Diagnoses and Dysphagia Severity

“…The significance of anxiety and affective comorbidities in the field of laryngology has been mostly investigated in relation to dysphonia 4–8 . Investigations in gastroenterology, however, have suggested that psychological factors, such as anxiety or hypervigilance, may exacerbate patients' symptoms beyond any objective physiologic abnormalities.…”

“…4 Depression has been associated with a nearly 2-fold increased chance of patients reporting voice problems. 5 Additionally, patients with a history of depression and anxiety are susceptible to developing functional voice disorders. [6][7][8] People with dysphagia often report associated anxiety and affective symptoms, as dysphagia impacts health and quality of life, notably through the disruption of the social aspect of sharing meals.…”

“…Studies have shown there is a correlation between anxiety and depression and higher Voice Handicap Index‐10 (VHI‐10) scores 4 . Depression has been associated with a nearly 2‐fold increased chance of patients reporting voice problems 5 . Additionally, patients with a history of depression and anxiety are susceptible to developing functional voice disorders 6–8 …”

Do You Like Your Voice? A Population‐Based Survey of Voice Satisfaction and Voice Enhancement

“…The sound of our own voice is a unique and familiar aspect of our self‐identity. Though the neurofunctional mechanisms of perception of one's own voice are not well understood, 1 patients with voice disorders have been shown to have significant decrement of quality‐of‐life, self‐esteem, and social function 2–7 . Studying patients' perceptions of their voices has become a valuable and actionable avenue of research within otolaryngology, and patient‐reported voice outcome measures are abundant 8 …”

“…Though the neurofunctional mechanisms of perception of one's own voice are not well understood, 1 patients with voice disorders have been shown to have significant decrement of qualityof-life, self-esteem, and social function. [2][3][4][5][6][7] Studying patients' perceptions of their voices has become a valuable and actionable avenue of research within otolaryngology, and patient-reported voice outcome measures are abundant. 8 Even among individuals without voice disorders, many report feeling uncomfortable when listening to their own voices or hearing recordings of their own voice; in these scenarios, many judge the sound of their own voice negatively.…”