Depression Among Teachers According to the Risk of Voice Disorders

Teachers are professional voice users. Long-term and intensive voice use, noisy environments, personal factors and occupational stress experienced by these professional voice users may negatively affect vocal health, along with psycho-emotional factors such as depression.

This cross-sectional and comparative study aimed to compare depressive symptoms between teachers at risk for voice disorders and those without such risk and to examine the relationship between depressive symptoms and voice-related disability levels among teachers at risk for voice disorders.

A total of 130 teachers were included in this study, comprising 64 participants in the study group and 66 in the control group. The Screening Index for Voice Disorder (SIVD-TR) was used to identify teachers at risk for voice disorders. Based on the SIVD-TR cutoff score, participants were divided into two groups: the study group (SIVD-TR ≥ 4; at risk for voice disorders) and the control group (SIVD-TR < 4; without risk). The Voice Handicap Index (VHI-10) was used to assess voice-related disability, and the Center for Epidemiologic Studies Depression Scale (CES-D) was employed to evaluate depressive symptoms and compare them between groups.

The mean years of professional experience and the average class size of the study group were higher than those of the control group, and this difference was found to be statistically significant (p < 0.05). The mean VHI-10 and CES-D scores of the study group were significantly higher compared to the control group (p < 0.001). Among the study group participants, there was a moderate and statistically significant positive correlation between SIVD-TR and VHI-10 scores (r = 0.429, p < 0.001), as well as between VHI-10 and CES-D scores (r = 0.413, p = 0.001). In addition, a weak but statistically significant positive correlation was observed between SIVD-TR and CES-D scores (r = 0.261, p = 0.037).

It was observed that teachers at risk for voice disorders had longer professional experience and taught in more crowded classrooms. Teachers at risk for voice disorders were found to have significantly higher levels of voice problems and depression symptoms compared to those not at risk. A relationship was identified between the level of voice-related disability and depression symptoms in this population. Early intervention through screening programs may support teachers' vocal health and psychological well-being. Therefore, it is essential to consider the psycho-emotional state of teachers at risk for voice disorders during the assessment and intervention processes.

What is already known on the subject Teachers are more likely to experience voice problems compared to the general population due to high vocal demands, large class sizes, number of students, classroom noise, insufficient humidity levels and occupational stress. Voice problems can negatively affect teachers' professional performance and quality of life. Additionally, it is known that psycho-emotional conditions such as depression are associated with voice and voice disorders. What this paper adds to the existing knowledge This study compared depressive symptoms among teachers at risk for voice disorders and those without, and explored the relationship between depressive symptoms and levels of voice-related disability among teachers at risk for voice disorders. Teachers at risk for voice disorders were found to have significantly higher levels of voice problems and depression symptoms compared to those not at risk. A relationship was identified between the level of voice-related disability and depression symptoms in this population. What are the potential or actual clinical implications of this work? The findings of this study indicate that clinical approaches to teachers' vocal health should not be limited to vocal function alone. Professionals working in the field of voice should consider the psychological state of teachers presenting with voice complaints alongside their vocal functioning during assessment and intervention processes. This research provides an evidence-based foundation to support multidisciplinary collaboration among speech and language therapists, psychological counsellors, psychiatrists, laryngologists and school administrators.