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Evaluation of Anxiety and Depression in Patients with Chronic Rhinosinusitis with Nasal Polyps
Pei-Wen Wu1,2,3, Po-Hung Chang1, Chi-Che Huang1,2
1Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
Purpose:
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a persistent inflammation of the sinuses accompanied by the formation of obstructive nasal polyps, which may lead to symptoms of common mental disorders, including anxiety and depression, as a result of long-term discomfort. This study aimed to investigate the associations of severe CRSwNP, with anxiety and depression.
Methods:
Adult patients with severe primary diffuse CRSwNP scheduled to undergo sinus surgery and healthy control participants were prospectively enrolled. Clinical data were collected and the Sinonasal Outcome Test-22 (SNOT-22), Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory (BAI) were used to evaluate quality of life.
Results:
Ninety-six patients with CRSwNP and 40 controls were enrolled in this study. Patients with CRSwNP exhibited significantly higher BAI scores than controls. However, BDI-II scores were not significantly different. Among the patients with CRSwNP, 32.3% exhibited possible anxiety, defined as a BAI score >7. Comorbid asthma, SNOT-22 score, and blood eosinophil percentage were significant factors associated with anxiety in patients with CRSwNP in univariate logistic regression analysis and comorbid asthma and SNOT-22 remained statistically significant in multivariable analysis. An SNOT-22 score > 57 was the optimal cutoff value for identifying patients with possible anxiety.
Conclusion:
A significant proportion of patients with CRSwNP exhibited anxiety symptoms. Comorbid asthma, SNOT-22 score, and blood eosinophil percentage were significant factors associated with the presence of anxiety. These findings emphasize the importance of screening for psychological symptoms and potentially integrating psychological assessments and interventions in the care of high-risk patients.
