title: Psychosocial distress in patients presenting with voice concerns.
abstract: OBJECTIVE
  To assess the prevalence of psychosocial distress (depression, anxiety, somatization, and perceived stress) in a consecutive sample of patients presenting with voice concerns and to qualitatively analyze patient comments on challenges associated with voice problems.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  New patients presenting to a multidisciplinary voice clinic with voice concerns were invited to participate. Respondents (n = 197) completed the Brief Symptom Inventory 18-item scale, the 4-item Perceived Stress Scale, and the Voice Handicap Index 10-item scale. Qualitative analysis was performed of responses to an open-ended question about challenges associated with a voice problem.
  
  
  RESULTS
  Approximately one-third (32%) of the patients met the strict case criteria for depression, anxiety, and/or somatic concerns based on the Brief Symptom Inventory 18-item scale. Most patients had no prior diagnosis of depression or anxiety, and the degree of distress was not predicted by the type of voice-related diagnosis. Perceived stress was higher among female patients (P = 0.02). As expected, scores on the Voice Handicap Index 10-item scale were indicative of concurrent voice-related handicap (mean, 19.5; standard deviation, 9.4). In qualitative analysis of responses regarding challenges associated with a voice problem, 19 themes were identified (eg, threat to occupational functioning).
  
  
  CONCLUSIONS
  These findings identify a high prevalence of multiple types of distress among patients with voice disorders, presenting an opportunity to provide more comprehensive care to this patient population.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, School of Medicine, University of Minnesota, Minneapolis, Minnesota. Electronic address: smisono@umn.edu.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Misono
authors.affiliation: Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Carol B
authors.initials: CB
authors.lastname: Peterson
authors.affiliation: Department of Psychology, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Liza
authors.initials: L
authors.lastname: Meredith
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, School of Medicine, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Banks
authors.affiliation: Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Dipankar
authors.initials: D
authors.lastname: Bandyopadhyay
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, School of Medicine, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Bevan
authors.initials: B
authors.lastname: Yueh
authors.affiliation: Department of Psychology, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Frazier
mesh_terms: D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D015995:Prevalence; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014831:Voice; D014832:Voice Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology
keywords: Anxiety; Depression; Dysphonia; Psychosocial distress; Somatization; Stress; Voice disorder