Correlation Between Anxiety, Depression, and Self-Perceived Hoarseness: A Case Series of 100 Lebanese Patients

To investigate the correlation between anxiety, depression, and self-perceived vocal handicap in Lebanese patients with voice disorders.

Prospective cohort.

All patients who presented to the voice clinic of a tertiary referral center with hoarseness between November 2023 and June 2024 were invited to participate in this prospective study. All patients were asked to complete the Voice Handicap Index-10 (VHI-10), the Generalized Anxiety Disorder scale-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9).

A total of 100 patients were enrolled in this study. The study group included 56 men and 44 women. The mean age of the participants was 46.03 ± 11.66 years. The mean VHI-10 score was 13.41 ± 6.39. Based on the GAD-7 score, 12 patients had minimal anxiety, 24 had mild anxiety, 43 had moderate anxiety, and 21 had severe anxiety. Patients with moderate or severe anxiety had a significantly higher VHI-10 score than those with minimal anxiety (P < 0.05). There was a mild positive correlation between level of anxiety and the VHI-10 score (r = 0.276). Based on the PHQ-9 score, 50 patients had minimal depression, 30 had mild depression, and 20 had moderate depression. Patients with moderate or mild depression had a significantly higher VHI-10 score than those with mild depression (P < 0.05). There was a mild positive correlation between level of depression and the VHI-10 score (r = 0.316).

Anxiety and depression are common in Lebanese patients with voice disorders. Self-perceived vocal handicap correlated positively with the level of anxiety and depression. A multidisciplinary approach is recommended to optimize treatment of patients with voice disorders and mental illnesses.