title: Voice problems and depression among adults in the United States.
abstract: Prior studies have observed a high prevalence of psychosocial distress, including depression, in patients with voice problems. However, these studies have largely been performed in care-seeking patients identified in tertiary care voice clinics. The objective of this study was to examine the association between depression and voice problems in the U.S.
  
  
  
  Cross-sectional analysis of National Health Interview Survey (NHIS) data.
  
  
  
  We identified adult cases reporting a voice problem in the preceding 12 months in the 2012 NHIS. Self-reported demographics and data regarding healthcare visits for voice problems, diagnoses given, severity of the voice problem, and depression symptoms were analyzed.
  
  
  
  The total weighted sample size was 52,816,364. The presence of depressive symptoms was associated with a nearly two-fold increase (odds ratio = 1.89, 95% confidence interval = 1.21-2.96) in the likelihood of reporting a voice problem in the past year. Patients who reported feeling depressed were less likely to receive care for the voice problem and less likely to report that treatment had helped than those who did not feel depressed.
  
  
  
  These findings indicate that the co-occurrence of voice problems and depressive symptoms is observed in the general population, not only in care-seeking patients, and that depressive symptoms may influence reported likelihood of receiving voice treatment and effectiveness. This suggests that voice care providers should take mental health symptoms into account when treating patients, and also indicates a need for further investigation.
  
  
  
  NA. Laryngoscope, 126:1859-1864, 2016.
authors.affiliation: Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota, U.S.A.|Department of Surgery, School of Medicine, University of Minnesota, Minneapolis, Minnesota, U.S.A.
authors.forename: Schelomo
authors.initials: S
authors.lastname: Marmor
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, U.S.A.
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Horvath
authors.affiliation: Department of Psychiatry, School of Medicine, University of Minnesota, Minneapolis, Minnesota, U.S.A.
authors.forename: Kelvin O
authors.initials: KO
authors.lastname: Lim
authors.affiliation: Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota, U.S.A.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Misono
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D014832:Voice Disorders / Q000150:complications*; D055815:Young Adult
keywords: NHIS; Voice problems; depression; dysphonia; population-based