title: Psychogenic dysphonia: diversity of clinical and vocal manifestations in a case series.
abstract: BACKGROUND
  Psychogenic dysphonia is a functional disorder with variable clinical manifestations.
  
  
  OBJECTIVE
  To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series.
  
  
  METHODS
  The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings.
  
  
  RESULTS
  28 patients (26 women and 2 men) were assessed. Their occupations included: housekeeper (n=17), teacher (n=4), salesclerk (n=4), nurse (n=1), retired (n=1), and psychologist (n=1). Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms.
  
  
  CONCLUSIONS
  In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed.
authors.affiliation: Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Botucatu, SP, Brazil. Electronic address: rmartins@fmb.unesp.br.
authors.forename: Regina Helena Garcia
authors.initials: RH
authors.lastname: Martins
authors.affiliation: Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Botucatu, SP, Brazil.
authors.forename: Elaine Lara Mendes
authors.initials: EL
authors.lastname: Tavares
authors.affiliation: Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Botucatu, SP, Brazil.
authors.forename: Paula Ferreira
authors.initials: PF
authors.lastname: Ranalli
authors.affiliation: Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Botucatu, SP, Brazil.
authors.forename: Anete
authors.initials: A
authors.lastname: Branco
authors.affiliation: Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Botucatu, SP, Brazil.
authors.forename: Adriana Bueno Benito
authors.initials: AB
authors.lastname: Pessin
mesh_terms: D000328:Adult; D000368:Aged; D055154:Dysphonia / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011602:Psychophysiologic Disorders / Q000175:diagnosis*
keywords: Clinical psychology; Distúrbios da voz; Psicologia clínica; Psicopatologia; Psicoterapia; Psychopathology; Psychotherapy; Voice disorders