title: Impact of posttraumatic stress disorder on sinonasal symptoms and quality of life in patients with chronic rhinosinusitis.
abstract: BACKGROUND
  Severity of chronic rhinosinusitis (CRS), measured by disease-specific health-related quality-of-life questionnaires, is expected to increase in patients who also suffer from posttraumatic stress disorder (PTSD). Altered pain perception, sleep disorders, and fatigue may be associated with this comorbidity.
  
  
  METHODS
  Severity of CRS was compared between a group of 28 patients with CRS and a group of 28 patients with CRS and concomitant PTSD using different disease-specific and generic instruments, such as visual analog scale (VAS), Short Form-36 test (SF-36), and Sino-Nasal Outcome Test-22 (SNOT 22).
  
  
  RESULTS
  SNOT-22 test showed significantly higher CRS severity in patients with CRS and PTSD, compared to patients with CRS without PTSD.
  
  
  CONCLUSIONS
  Patients with less severe CRS, measured by objective outcome measures, due to the impact of comorbid PTSP, are classified as having severe rhinosinusitis, and are exposed to the risk of unnecessary diagnostic and therapeutic procedures. In patients with difficult-to-treat rhinosinusitis, diagnosis should be revised, and one item that should be evaluated is whether they suffer from PTSD.
authors.affiliation: Division of Otorhinolaryngology, Pakrac City Hospital, Pakrac, Croatia.
authors.forename: Dražen
authors.initials: D
authors.lastname: Shejbal
authors.forename: Davor
authors.initials: D
authors.lastname: Vagić
authors.forename: Siniša
authors.initials: S
authors.lastname: Stevanović
authors.forename: Elvira
authors.initials: E
authors.lastname: Koić
authors.forename: Livije
authors.initials: L
authors.lastname: Kalogjera