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The relationship between depressive symptoms and voice handicap index scores in laryngopharyngeal reflux

Authors

  • Jackson C. Elam BS,

    1. Department of Otolaryngology–Head and Neck SurgeryJohns Hopkins Medical Institutions, Baltimore, Maryland, U.S.A.
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  • Stacey L. Ishman MD,

    1. Department of Otolaryngology–Head and Neck SurgeryJohns Hopkins Medical Institutions, Baltimore, Maryland, U.S.A.
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  • Kerry B. Dunbar MD,

    1. Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, U.S.A.
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  • John O. Clarke MD,

    1. Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, U.S.A.
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  • Christine G. Gourin MD

    Corresponding author
    1. Department of Otolaryngology–Head and Neck SurgeryJohns Hopkins Medical Institutions, Baltimore, Maryland, U.S.A.
    • Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, 601 N. Caroline Street, Suite 6260, Baltimore, MD 21287
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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

To determine if a relationship exists between depression and Voice Handicap Index (VHI) scores in patients with laryngopharyngeal reflux (LPR) disease.

Study Design:

Retrospective analysis of prospectively collected data.

Methods:

One hundred nineteen patients were prospectively evaluated with the VHI questionnaire and the Beck Depression Inventory Fast Screen (BDI-FS) survey. Patients with a pre-existing diagnosis of depression were excluded.

Results:

Complete data was available for 36 patients with LPR and 53 controls. No significant differences existed between groups with respect to age, race, or gender. Mild depressive symptoms were identified in 9% of controls and 3% of LPR patients by BDI-FS screening (P = .4); no patients had moderate or severe depression symptoms. Compared to controls, patients with LPR had significantly higher mean scores for total VHI (16.2 vs. 6.6, P = .002), functional VHI (5.8 vs. 2.4, P = .02), and physical VHI (6.9 vs. 2.5, P = .008) domains. Mean scores for the VHI emotional domain (3.5 vs. 1.7, P = .2) and BDI-FS (0.2 vs. 0.8, P = .3) did not differ between patients with LPR and controls. For all participants, a positive correlation was found between BDI-FS score and VHI emotional domain score (r = 0.3, P = .008).

Conclusions:

Patients with LPR report poorer VHI functional and physical scores compared to controls; however, LPR symptoms do not result in significantly worse VHI emotional domain scores or depressive symptoms. There is a correlation between VHI emotional domain scores and BDI-FS scores. These data suggest that LPR patients with poor VHI emotional domain scores might benefit from screening for depressive symptoms. Laryngoscope, 2010

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