Anxiety and depression in spasmodic dysphonia patients

OBJECTIVE/HYPOTHESIS: Experts used to believe that spasmodic dysphonia (SD) was a psychogenic disorder. Although SD is now established as a neurological disorder, the rates of co-morbid anxiety and depression range from 7.1% to 62%. Our objective was to study the prevalence and risk factors associated with these mood disorders in SD patients. STUDY DESIGN: Retrospective. METHODS: SD patients who presented for botulinum toxin injections were recruited. Demographic data, Hospital Anxiety and Depression Scale (HADS), Voice Handicap Index-10 (VHI-10), General Self-Efficacy scale (GSES), Disease Specific Self-Efficacy in Spasmodic Dysphonia scale (DSSE), and Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) were collected. RESULTS: One hundred and forty two patients (age (59.2 ± 13.6) years, 25.4% male) had VHI-10 of 26.3 ± 6.9 (mean ± standard deviation), GSES 33.2 ± 5.8, CAPE-V 43.9 ± 20.9, HADS anxiety 6.7 ± 3.7, and HADS depression 3.6 ± 2.8. About 19 (13.4%) and 4 (2.8%) had symptoms of anxiety and depression respectively. Final linear regression model for HADS anxiety (R(2) = 32.90%) showed that patients who were less likely to have anxiety symptoms were older age (p < 0.001), male (p = 0.002), have higher GSES (p < 0.001) and lower VHI-10 (p = 0.004). Final linear regression model for HADS depression score (R(2) = 34.42%) showed that patients who were less likely to have depressive symptoms had high DSSES (p < 0.001). CONCLUSIONS: Prevalence of anxiety (13.4%) and depression (2.8%) in SD were lower than previously reported in the literature. Risk factors for anxiety were: younger age, female gender, lower general self-efficacy, and higher perceived vocal handicap. The main risk factor for depression was lower disease specific self-efficacy.