title: Long term outcome of psychogenic voice disorders.
abstract: OBJECTIVE
  To evaluate different therapy for psychogenic voice disorders.
  
  
  METHODS
  Epidemiological data, organic and psychological symptoms, therapeutic options and outcome were prospectively analyzed in 40 consecutive patients with psychogenic voice disorders. Their voice was evaluated by subjective means and self assessment (voice handicap index) and an organic or functional disorder was excluded by videolaryngostroboscopy. Additionally, a detailed psychological examination and exploration were made. Every patient received intensive voice exercises with biofeedback by a phoniatrician and counseling by a clinical psychologist. Following this, therapy options of psychotherapy or a combination of psychotherapy and voice therapy were given. After an interval (average 16 months) from first contacting our section, every patient was asked to complete a questionnaire about their therapies and quality of voice.
  
  
  RESULTS
  Patients had previously received insufficient voice therapy or antibiotics. The psychological examination detected psychological disorders as a basic problem. Overall, in 70% of patients there was either an improvement or resolution of voice problems. For all patients psychotherapy or a combination of voice therapy and psychotherapy was recommended, but only accepted in 37.5%. In all cases, when psychotherapy in combination with speech therapy took place, it was successful, whereas speech therapy alone provided improvement only in 12.5%.
  
  
  CONCLUSIONS
  Psychogenic voice disorders are often misdiagnosed, leading to inadequate therapy. Psychotherapy (often in combination with voice therapy) was most effective also in the long term, but is often not accepted by patients. Voice therapy alone had a poor success rate.
authors: Department of Otolaryngology Head and Neck Surgery, Section of Phoniatrics and Pedaudiology, University of Ulm, Frauensteige 12, Ulm, Germany. rudolf.reiter@uniklinik-ulm.de
authors: Rudolf
authors: R
authors: Reiter
authors: Dieter
authors: D
authors: Rommel
authors: Sibylle
authors: S
authors: Brosch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001676:Biofeedback, Psychology; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011613:Psychotherapy; D013001:Somatoform Disorders / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014832:Voice Disorders / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D014833:Voice Quality; D014834:Voice Training; D055815:Young Adult