Relationship between Mental and Vocal Health in Occupational Voice Users: A Systematic Literature Review

Identify the trends in research related to bibliometric analysis and investigate the bidirectional impact of mental health concerns and vocal health issues.

Systematic literature review following the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 statement. Six computerized databases were searched independently by three authors through February 2025 using MESH terms. Bibliometric analysis was completed using VOSviewer software to analyze co-occurrence in key terms. We used the Quality Assessment Tool for Quantitative Studies to rate the methodological quality of each included publication.

In total, 181 records were retrieved. After removing duplicates, non-indexed manuscripts, and book chapters, 147 records were retained. Titles and abstracts were screened, and after applying the inclusion criteria, 49 publications were included for full-text review. After full-text screening, 20 manuscripts were retained for this systematic review. Among the included publications, 75% focused on school teachers, one on teachers, two on university teachers, and one on religious officials. The most common voice assessment tool was the Voice Handicap Index. Eleven publications reported anxiety as the mental health outcome, 50% reported stress, and 45% reported depression. Voice problems were often related to emotional factors. Teachers experiencing voice problems reported a lower quality of life, more stress, fatigue, and exhaustion, while those with an experienced or physiologic voice problem scored significantly lower on both physical and mental health scales compared to those without problems. Burnout syndrome was associated with the likelihood of having a voice disorder.

This review highlights the intricate and reciprocal relationship between vocal and mental health among occupational voice users and teachers in particular. The findings underscore the need for interdisciplinary approaches that address both physical and psychological dimensions of occupational health. By integrating preventive strategies, clinical screening, and workplace interventions, stakeholders can promote well-being and sustainability in the teaching profession.