Erskine S E, Hopkins C, Clark A, Anari S, Robertson A, Sunkaraneni S, Wilson J A, Beezhold J, Philpott C M
Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
Guys and St Thomas NHS Foundation Trust, London, United Kingdom.
Rhinology. 2017 Jun 1;55(2):113-119. doi: 10.4193/Rhin16.111.
This study is part of the Chronic Rhinosinusitis Epidemiology Study (CRES). The overarching aim is to determine factors that influence the onset and severity of chronic rhinosinusitis (CRS). The aim of this analysis is to determine whether those with CRS are more likely to report psychiatric morbidity and in particular mood disturbance compared with healthy controls.
CRES consists of a study-specific questionnaire regarding demographic and socioeconomic factors and past medical history as well as a nasal symptom score (SNOT-22) and SF-36 (QoL - quality of life tool). Both of these tools contain mental health or emotional well-being domains. Participants were specifically asked whether they had ever consulted with their General Practitioner for anxiety or depression. Questionnaires were distributed to patients with CRS attending ENT outpatient clinics at 30 centres across the United Kingdom from 2007-2013. Controls were also recruited at these sites. Patients were divided into subgroups of CRS according to the absence/presence of polyps (CRSsNPs/CRSwNPs) or allergic fungal rhinosinusitis (AFRS).
Consultations with a family physician for depression or anxiety were higher amongst those with CRS than controls, but this was only significant for those with CRSsNPs. Odds ratio (OR) for CRSsNPs vs controls: 1.89; OR for CRSwNPs: 1.40. Patients with CRS showed significantly higher mental health morbidity than controls across the mental health and emotional wellbeing domains of the SF-36 and SNOT-22. Mean difference in the mental health domain of SF-36 was 8.3 for CRSsNPs and 5.3 for CRSwNPs. For the emotional domain of SNOT-22, differences were 7.7 and 6.3 respectively.
Depression and anxiety are significantly more common in patients with CRS compared to healthy controls, especially in those with CRSsNPs. This added mental health morbidity needs consideration when managing these patients in primary and secondary care settings.
本研究是慢性鼻窦炎流行病学研究（CRES）的一部分。总体目标是确定影响慢性鼻窦炎（CRS）发病和严重程度的因素。本分析的目的是确定与健康对照组相比，CRS患者是否更有可能报告精神疾病，尤其是情绪障碍。
CRES包括一份关于人口统计学和社会经济因素以及既往病史的特定研究问卷，以及一份鼻症状评分（SNOT-22）和SF-36（生活质量工具）。这两种工具都包含心理健康或情绪健康领域。特别询问了参与者是否曾因焦虑或抑郁咨询过全科医生。2007年至2013年期间，向英国30个中心的耳鼻喉科门诊就诊的CRS患者发放了问卷。对照组也在这些地点招募。根据是否存在息肉（CRSsNPs/CRSwNPs）或变应性真菌性鼻窦炎（AFRS），将患者分为CRS亚组。
CRS患者因抑郁或焦虑咨询家庭医生的比例高于对照组，但仅在CRSsNPs患者中具有统计学意义。CRSsNPs与对照组的比值比（OR）：1.89；CRSwNPs的OR：1.40。在SF-36和SNOT-22的心理健康和情绪健康领域，CRS患者的心理健康发病率显著高于对照组。SF-36心理健康领域的平均差异，CRSsNPs为8.3，CRSwNPs为5.3。对于SNOT-22的情绪领域，差异分别为7.7和6.3。
与健康对照组相比，CRS患者的抑郁和焦虑明显更为常见，尤其是在CRSsNPs患者中。在初级和二级护理环境中管理这些患者时，需要考虑这种额外的心理健康发病率。
