SUMMARY
Objectives
To evaluate the correlation between voice disorders and psychological distress, in
terms of anxiety, stress, and depression, in a sample of adult Italian patients and
to compare our results with those obtained in a group of adult healthy controls matched
by age, sex, geographic distribution, and occupation.
Methods
This prospective-controlled study included 100 adults with Vocal nodules (VN) and
Muscle Tension Dysphonia (MTD1), aged between 18 and 65 years, as Experimental Group
(EG) and 100 age-matched subjects without any voice disorders as a Control Group (CG).
All patients in the EG underwent a phoniatric evaluation, including the administration
of the Voice Handicap Index (VHI) and laryngeal examination. Both patients of EG and
CG underwent a Psychological evaluation by means of standardized tests; Beck's Depression
Inventory, State Anxiety Inventory (STAI 1-State Anxiety), Trait Anxiety Inventory
(STAI 2- Trait Anxiety), and Perceived Stress Scale (PSS-10) were completed by patients.
Fisher's exact test and chi-squared test were used to compare all categorical variables,
whereas numerical variables were compared either with the nonparametric Mann-Whitney-Wilcoxon
or with Kruskal Wallis test. General linear models were used to study continuous variables
between patients and controls and between different groups within the sample.
Results
In the study group, the Physical domain (P score) of the VHI was more affected than the Emotional (E score) and Functional ones
(F score) both in patients with MTD1 and VN; patients with VN presented a significant
difference in P score, E score and VHI total score than patients with isolated MTD
1 (P < 0.005). Psychological assessment showed a significant difference (P < 0.005) between VN and MTD 1 regarding PSS-10 and STAI-1 scores. Low Beck's Depression
Inventory scores were present in our sample without significant differences between
patients with VN and those with MTD 1. Scores related to psychological distress in
the EG were far superior to those obtained by the healthy CG, with markedly significant
values especially for PSS-10 (P < 0.0001) and STAI 2 (P < 0.01). Finally, younger patients (18-35 years) with VN showed a highest risk of
psychosocial distress.
Conclusion
the present study identified a high prevalence of psychological distress among patients
with vocal disorders without any prior specific psychiatric diagnosis, especially
in terms of anxiety and perceived stress. For this reason both these symptoms should
be taken into consideration in the diagnostic, therapeutic, and follow-up process
of patients with MTD1 and VN.
Key Words
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Article info
Publication history
Published online: December 30, 2020
Accepted:
December 10,
2020
Footnotes
Declarations of interest: none
Identification
Copyright
© 2020 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
