Psychiatric disturbance and personality traits in dysphonic patients

A study of 68 consecutive attendees at a voice clinic revealed that 51 (75%) were female. Personality characteristics and the incidence of minor psychiatric disturbances were studied in the 51 female patients with dysphonia and in 42 female ENT outpatient control subjects. Personality was assessed by use of the Eysenck Personality Questionnaire (EPQ) and the Hysteroid-Obsessoid Questionnaire (HOQ), and psychiatric disturbance was assessed by use of the General Health Questionnaire (GHQ), 60-item version. Whereas the 18 patients who were diagnosed as having psychogenic dysphonia had, overall, a greater degree of mild psychiatric disturbance, the 33 patients whose dysphonia was associated with structural laryngeal abnormality were also significantly more disturbed than control subjects (p < 0.01). There were no significant differences in personality traits among the three groups. Ten of the 18 patients with psychogenic dysphonia had evidence of significant psychiatric symptomatology on GHQ testing. More unexpectedly, one in three of the women with structural laryngeal changes showed similar psychiatric disturbance. Such psychological distress cannot therefore be detected solely on laryngeal appearances and voice characteristics. We propose the GHQ to be a quick, simple screening tool to identify those patients who might benefit from a more psychologically based approach to therapy.