Laryngopharyngeal reflux and psychological distress: a vicious cycle worth investigating

To investigate the correlation between laryngopharyngeal reflux (LPR) and psychological distress in a sample of adult Italian patients.

LPR was assessed using the Reflux Symptom Index (RSI), Reflux Finding Score (RFS), and 24-hour impedance-pH monitoring. Psychological distress was evaluated with the following clinical tools: the Hospital Anxiety and Depression Scale (HADS), the Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), the Impact of Event Scale-Revised (IES-R), the Insomnia Severity Index (ISI), and the Perceived Stress Scale-10 (PSS-10). Associations between RSI, RFS, and psychological scores were analyzed.

A total of 45 patients with LPR (Study Group, SG) and 29 healthy volunteers (Control Group, CG) were included in the study. Psychological assessments revealed significant differences between the CG and SG, except for the ISI. The HAM-A score was 6.79 ± 6.5 in the CG versus 9.53 ± 5.8 in the SG (p = 0.025), with similar results for the HADS (p = 0.029). For the HAM-D, mean scores in both groups were below the threshold for mild depressive symptoms, though SG scores were just below the cut-off (CG: 4.86 ± 5.1; SG: 6.89 ± 4.1; p = 0.010). The PSS-10 indicated mild to moderate perceived stress, with significantly higher scores in the SG (CG: 13.90 ± 5.5; SG: 21.62 ± 8.1; p = 0.000). RSI scores were positively correlated with HAM-D, HADS, and HAM-A scores.

Psychological distress is significantly higher in LPR patients compared to healthy controls. These preliminary findings suggest that psychological factors should be considered in the management of LPR.