Chronic stress and anxiety-depressive spectrum disorders in patients of phoniatric practice

Abstract

Objectives

To research the influence of stress factors on the development and circuit of voice disorders in their relation to anxiety and depressive spectrum.

Aimes

To analyze the extent to which the anxiety and depressive disorders are spreading among the patients with voice dysfunctions, to determine the variety of factors for psychological traumatic experience, and to distinguish the variety of anxiety and depressive disorders.

Methods

The Hospital Anxiety and Depression Rating Scale (HADS), the projective psychological tests.

Preliminary HADS screening was conducted among 180 patients. More than half of the patients (57.5%) had high risk of anxiety and depressive disorders. 55 patients (44 women, 13 men, age of 18–70) with voice disorders and the positive results of screening were included to the study. Patients underwent a complete otolaryngologic examination and were grouped into organic voice pathology (34.5%) and non-organic voice pathology (65.5%). In accordance with ICD-10, anxiety and depressive disorders were diagnosed in 48 (87%) patients. In most cases (98.7%) the phoniatric pathology developed in chronic stress conditions. The prevailed chronic stress factors that provoked both anxiety-depressive spectrum disorders and voice pathology were inability to reach pre-set social goal (65.4%), ethical conflict (18.2%) and lack of external control factors (16.4%). Professional factor was also important as 38.2% of the group claimed heavy voice load at work.

Chronic stress factors play significant provoking role in the development of voice and anxiety-depressive spectrum disorders, which should be taken into account to design diagnostic and therapeutic tactics for patients with voice pathology.