Psychological distress in patients with benign voice disorders

The aims of this study were to investigate the frequency of anxiety and depression in patients with benign voice disorders with respect to gender and diagnosis and to determine correlations between psychological distress and some sociodemographic factors and the Voice Handicap Index (VHI).

Psychological distress was assessed for 437 consecutive adult patients with benign voice disorders and 88 healthy controls by a standardized Hospital Anxiety and Depression Scale (HADS). In addition, sociodemographic factors, unhealthy habits and VHI were investigated.

Mild to severe HADS-Anxiety scores were seen in 42.1% of the whole patient group, while mild to severe HADS-Depression scores were seen in only 19.2% of patients. The anxiety rate rather than the depression rate in voice patients was found to be significantly higher compared to controls (p < 0.05). Female patients expressed more anxiety than males. HADS-Anxiety scores were similar for most benign voice disorders. The worst depression scores were found in patients with vocal fold paralysis. Higher psychological distress was significantly related to female gender, older age, less education and higher VHI scores.

We recommend screening for psychological distress in patients with benign voice disorders using a simple HADS tool to identify those patients who might benefit from a more psychologically based approach to therapy.