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[Do psychological factors change in patients with spasmodic dysphonia after injections with botulinum-toxin?]
C Kiese-Himmel1, M Reeh, H Liebeck
1Abteilung Phoniatrie und Pädaudiologie der Georg-August-Universität Göttingen, Germany. ckiese@med.uni-goettingen.de
Objective:
A pre-/posttherapeutic comparative study was carried out to investigate possible associations of voice symptoms, selected psychological factors and their changing.
Sample:
A total of 11 patients with spasmodic dysphonia (adductor-type) subjected to botulinum-toxin-therapy. Patients had received treatment without any complications for at least 2 years. During that period of time, they received a minimum of 3 and a maximum of 9 injections (mean: 6).
Methods:
Psychosocial data were measured before and after treatment using standardized psychological methods. The time span between measurements ranged from 1;8 to 4;6 years, with an average of 2;1 years.
Results:
On average, no somatic disorder, no clinically meaningful states of anxiety or pathological manifestations of personality traits could be detected, neither pre- nor posttherapeutically. The average stress load caused by life-changing-events was unobtrusive. Before treatment, 5 of 11 patients had an affective disorder in terms of a depressed mood. This caused a higher than average mean depressivity score for the group as a whole. It was no longer found posttherapeutically.
Conclusion:
The depression is interpreted as a psychic reaction. An association between spasmodic voice symptoms and psychosocial genesis could not be proved.