Dysphonia Is Associated With Anxiety and Depression in the All of Us Research Program

Previous studies have examined the relationship between dysphonia and mental health, but often in small samples and not across age groups. In this large national epidemiological study, we examine if dysphonia is related to anxiety and depression generally and across cohorts of different ages.

This is a cross-sectional analysis of adults ≥ 18 years old in the All of Us dataset. The exposure was dysphonia (ICD-10 code R49.0), and the outcomes were anxiety (ICD-10 F41) and depression (ICD-10 F32-33). We performed multivariable logistic regression analyses, controlling for age, gender, race, ethnicity, insurance, education, smoking history, alcohol use, and medical comorbidities. A sub-analysis compared depression and anxiety odds across two and five age groups.

Of 283,137 adults in our sample, the mean age was 56 years (standard deviation 16 years). Sixty-one percent identified as female. Controlling for covariates, those with dysphonia had 1.34 times (95% CI 1.27-1.41) the odds of depression and 1.44 times (1.37-1.52) the odds of anxiety compared to their non-dysphonia counterparts. After stratifying by age, the odds of depression and anxiety were 2.36 times (1.67-3.35) and 1.62 (1.14-2.30) respectively for participants ≥ 18-30 years old, 1.61 (1.37-1.89) and 1.75 (1.49-2.07) for > 30-45 year olds, 1.38 (1.23-1.55) and 1.46 (1.33-1.67) for > 45-60 year olds, 1.33 (1.23-1.44) and 1.46 (1.35-1.58) for > 60-75 year olds, and 1.22 (1.09-1.35) and 1.36 (1.22-1.51) for > 75 year olds.

Those with dysphonia had higher odds of depression and anxiety. Following stratification by age, the odds for each were highest for the youngest age group.