Analysis of VHI-10 in Patients with Comorbid Primary Muscle Tension Dysphonia and Emotional Disturbances

The goal of this study was to determine if coexisting emotional disturbance affects Voice Handicap Index-10 (VHI-10) scores in patients with primary muscle tension dysphonia (pMTD). We hypothesize that those with emotional disturbances will have a higher perceived voice handicap, and therefore higher VHI-10 scores.

Retrospective chart review.

We reviewed the medical charts of patients diagnosed with pMTD at initial voice evaluation in 2019. We included patients in the emotional disturbances group if they self-reported depression, anxiety, or acute stress; were diagnosed with a depressive episode, major depressive disorder, anxiety disorder, or severe acute stress episode; or received a score ≥5 on the Patient Health Questionnaire-9 depression screener, indicating at least mild levels of depression. We used univariable and multivariable linear regression models to analyze the severity of VHI-10 scores, prevalence of abnormal VHI-10 scores, and compare International Classification of Diseases, Tenth Revision diagnoses and VHI-10 scores between groups.

Three-hundred twenty-nine patients met the selection criteria. One-hundred nineteen patients had an emotional disturbance, and 210 patients did not. There was no significant association between higher VHI-10 scores and patients with emotional disturbances. Patients with a diagnosis of depressive episode had higher VHI-10 scores, with an average of 15.7, compared to the rest of the sample, with an average of 11.7 (P = 0.01). No association was found between higher VHI-10 scores and diagnosis of anxiety, though anxiety was the most common comorbidity with depression. An increase in age was also found to correlate with an increase in VHI-10 score, and identifying as Hispanic or Latino was correlated with lower VHI-10 scores.

Patients with coexisting emotional disturbance and pMTD do not have significantly higher perceived voice handicap than patients with pMTD and no emotional disturbance. Patients with pMTD and a history of depressive episode had greater perceived voice handicap.