Department of Otolaryngology, The Emory Voice Center, Emory University, Atlanta, Georgia 30308, USA.
J Voice. 2012 Sep;26(5):667.e1-6. doi: 10.1016/j.jvoice.2011.08.011. Epub 2011 Dec 29.
There is evidence supporting an association between depression and anxiety in patients with chronic disease. Spasmodic dysphonia (SD) is a chronic, incurable, and disabling voice disorder. Reported rates of depression and anxiety in SD range from 7.1% to 72%, with a maximum number of 18 patients. The goal of this study was to define the coprevalence of depression and anxiety with SD.
A single-institution case-control study was performed from May to July 2010. Consecutive patients with SD and benign voice disorders were enrolled prospectively. On enrollment, patients were asked to fill out a questionnaire that reviewed the duration of the voice disorder and personal history of anxiety and depression, including current and lifetime diagnosis.
One hundred forty-six controls with benign voice disorders and 128 patients with SD were enrolled. Patients with SD were no more likely to be diagnosed with depression or anxiety than those of the control group (odds ratio [OR]=0.985, 95% confidence interval [CI]=0.59-1.63; and OR=1.314; 95% CI=0.75-2.3, respectively). Additionally, duration of disease was a risk factor for depression in both the SD group and the control group, and the association was not significantly different between groups.
Patients with SD were no more likely to have depression or anxiety than those with other voice disorders. It is important for otolaryngologists to be aware of the increased rates of depression in patients diagnosed with chronic diseases, including voice disorders, and to refer to a psychiatrist when appropriate.
有证据表明,慢性疾病患者中存在抑郁和焦虑之间的关联。痉挛性发音障碍(SD)是一种慢性、无法治愈且使人致残的嗓音障碍。SD 患者的抑郁和焦虑发生率从 7.1%到 72%不等,最多有 18 名患者。本研究的目的是确定 SD 与抑郁和焦虑的共病率。
2010 年 5 月至 7 月进行了一项单机构病例对照研究。前瞻性纳入连续患有 SD 和良性嗓音障碍的患者。在入组时,患者被要求填写一份问卷,问卷回顾了嗓音障碍的持续时间以及焦虑和抑郁的个人病史,包括当前和终身诊断。
共纳入 146 名良性嗓音障碍对照者和 128 名 SD 患者。SD 患者被诊断为抑郁或焦虑的可能性并不比对照组患者高(比值比 [OR]=0.985,95%置信区间 [CI]=0.59-1.63;和 OR=1.314;95% CI=0.75-2.3)。此外,疾病持续时间是 SD 组和对照组中抑郁的危险因素,且两组之间的关联无显著差异。
SD 患者患抑郁或焦虑的可能性并不高于其他嗓音障碍患者。耳鼻喉科医生应注意到包括嗓音障碍在内的慢性疾病患者中抑郁发生率的增加,并在适当情况下转介给精神科医生。