Coprevalence of anxiety and depression with spasmodic dysphonia: a case-control study.

INTRODUCTION There is evidence supporting an association between depression and anxiety in patients with chronic disease. Spasmodic dysphonia (SD) is a chronic, incurable, and disabling voice disorder. Reported rates of depression and anxiety in SD range from 7.1% to 72%, with a maximum number of 18 patients. The goal of this study was to define the coprevalence of depression and anxiety with SD. MATERIALS AND METHODS A single-institution case-control study was performed from May to July 2010. Consecutive patients with SD and benign voice disorders were enrolled prospectively. On enrollment, patients were asked to fill out a questionnaire that reviewed the duration of the voice disorder and personal history of anxiety and depression, including current and lifetime diagnosis. RESULTS One hundred forty-six controls with benign voice disorders and 128 patients with SD were enrolled. Patients with SD were no more likely to be diagnosed with depression or anxiety than those of the control group (odds ratio [OR]=0.985, 95% confidence interval [CI]=0.59-1.63; and OR=1.314; 95% CI=0.75-2.3, respectively). Additionally, duration of disease was a risk factor for depression in both the SD group and the control group, and the association was not significantly different between groups. CONCLUSION Patients with SD were no more likely to have depression or anxiety than those with other voice disorders. It is important for otolaryngologists to be aware of the increased rates of depression in patients diagnosed with chronic diseases, including voice disorders, and to refer to a psychiatrist when appropriate.

[1]  R. Kessler,et al.  Age patterns in the prevalence of DSM-IV depressive/anxiety disorders with and without physical co-morbidity , 2008, Psychological Medicine.

[2]  G. Canino,et al.  Co-occurrence of mental and physical illness in US Latinos , 2006, Social Psychiatry and Psychiatric Epidemiology.

[3]  L. McWilliams,et al.  Mood and anxiety disorders associated with chronic pain: an examination in a nationally representative sample , 2003, Pain.

[4]  B. Dohrenwend,et al.  Adversity, stress, and psychopathology , 1998 .

[5]  A. Aronson,et al.  Psychiatric symptomatology in functional dysphonia and aphonia. , 1966, Journal of Speech and Hearing Disorders.

[6]  W. Katon,et al.  The impact of major depression on chronic medical illness. , 1996, General hospital psychiatry.

[7]  C. Veitch,et al.  The medical and retrieval costs of road crashes in rural and remote northern Queensland, 2004–2007: findings from the Rural and Remote Road Safety Study , 2009, The Medical journal of Australia.

[8]  K. Wells,et al.  Chronic medical conditions in a sample of the general population with anxiety, affective, and substance use disorders. , 1989, The American journal of psychiatry.

[9]  R. Kessler,et al.  Association between obesity and psychiatric disorders in the US adult population. , 2006, Archives of general psychiatry.

[10]  A. Gulledge.  Massachusetts General Hospital Handbook of General Hospital Psychiatry , 1979 .

[11]  J. Ormel,et al.  Comorbidity of physical and mental disorders and the effect on work‐loss days , 2005, Acta psychiatrica Scandinavica.

[12]  P. Bloch.  NEURO-PSYCHIATRIC ASPECTS OF SPASTIC DYSPHONIA. , 1965, Folia phoniatrica.

[13]  K. Wells,et al.  Psychiatric disorder in a sample of the general population with and without chronic medical conditions. , 1988, The American journal of psychiatry.

[14]  K. Merikangas,et al.  Associations between anxiety disorders and physical illness , 2003, European archives of psychiatry and clinical neuroscience.

[15]  W. Wodchis,et al.  Longitudinal effects of Botox injections on voice-related quality of life (V-RQOL) for patients with adductory spasmodic dysphonia: part II. , 2004, Archives of otolaryngology--head & neck surgery.

[16]  H. Gündel,et al.  Psychiatric comorbidity in patients with spasmodic dysphonia: a controlled study , 2007, Journal of Neurology, Neurosurgery, and Psychiatry.

[17]  M. Wallander,et al.  Study of a cohort of patients newly diagnosed with depression in general practice: prevalence, incidence, comorbidity, and treatment patterns. , 2010, Primary care companion to the Journal of clinical psychiatry.

[18]  W. Wodchis,et al.  Longitudinal effects of botulinum toxin injections on voice-related quality of life (V-RQOL) for patients with adductory spasmodic dysphonia. , 2001, Journal of voice : official journal of the Voice Foundation.

[19]  K. Vrtička,et al.  [Spastic dysphonia]. , 1976, ORL; journal for oto-rhino-laryngology and its related specialties.

[20]  Emotional symptoms are secondary to the voice disorder in patients with spasmodic dysphonia. , 1998, General hospital psychiatry.

[21]  P. Moses.  The Voice of Neurosis , 1954 .

[22]  A. Aronson,et al.  Spastic dysphonia. II. Comparison with essential (voice) tremor and other neurologic and psychogenic dysphonias. , 1968, The Journal of speech and hearing disorders.

[23]  M. Dew.  Psychiatric disorder in the context of physical illness. , 1998 .

[24]  I. Ilias,et al.  A comparative study of anxiety and depression in patients with bronchial asthma, chronic obstructive pulmonary disease and tuberculosis in a general hospital of chest diseases , 2008, Annals of general psychiatry.

[25]  N. Cassem,et al.  Massachusetts General Hospital Handbook of General Hospital Psychiatry , 2004 .

[26]  R. Kessler,et al.  Comorbidity of DSM–III–R Major Depressive Disorder in the General Population: Results from the US National Comorbidity Survey , 1996, British Journal of Psychiatry.

[27]  C. Adler,et al.  Female predominance in spasmodic dysphonia , 1997, Journal of neurology, neurosurgery, and psychiatry.

[28]  J. Staab,et al.  The Prevalence of Major Psychiatric Pathologies in Patients with Voice Disorders , 2003, Ear, nose, & throat journal.

[29]  D. Clarke,et al.  Depression, anxiety and their relationship with chronic diseases: a review of the epidemiology, risk and treatment evidence , 2009, The Medical journal of Australia.