Psychosocial distress in patients presenting with voice concerns

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32 Scopus citations


Objectives 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. Study Design 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.

Original languageEnglish (US)
Pages (from-to)753-761
Number of pages9
JournalJournal of Voice
Issue number6
StatePublished - Nov 1 2014

Bibliographical note

Funding Information:
The work was supported by NIH P30DK50456, R34MH077571, and UL1TR000114. The gracious support of clinic colleagues Deirdre D. Michael, PhD, CCC-SLP, Lisa Butcher, MM, MA, CCC-SLP, Hiland Overgaard, BA, and George S. Goding Jr, MD, FACS, is very much appreciated. Assistance from research coordinator Patricia Fernandes Boettner, DDS, and research assistants Sarah Cooper and Meg Her was also invaluable for the completion of this study.

Publisher Copyright:
© 2014 The Voice Foundation.


  • Anxiety
  • Depression
  • Dysphonia
  • Psychosocial distress
  • Somatization
  • Stress
  • Voice disorder


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