Analysis of VHI-10 in Patients with Comorbid Primary Muscle Tension Dysphonia and Emotional Disturbances.

OBJECTIVES/HYPOTHESIS: The goal of this study was to determine if coexisting emotional disturbance affects Voice Handicap Index-10 (VHI-10) scores in patients with primary muscle tension dysphonia (pMTD). We hypothesize that those with emotional disturbances will have a higher perceived voice handicap, and therefore higher VHI-10 scores.

STUDY

DESIGN

Retrospective chart review.

METHODS

We reviewed the medical charts of patients diagnosed with pMTD at initial voice evaluation in 2019. We included patients in the emotional disturbances group if they self-reported depression, anxiety, or acute stress; were diagnosed with a depressive episode, major depressive disorder, anxiety disorder, or severe acute stress episode; or received a score ≥5 on the Patient Health Questionnaire-9 depression screener, indicating at least mild levels of depression. We used univariable and multivariable linear regression models to analyze the severity of VHI-10 scores, prevalence of abnormal VHI-10 scores, and compare International Classification of Diseases, Tenth Revision diagnoses and VHI-10 scores between groups.

RESULTS

Three-hundred twenty-nine patients met the selection criteria. One-hundred nineteen patients had an emotional disturbance, and 210 patients did not. There was no significant association between higher VHI-10 scores and patients with emotional disturbances. Patients with a diagnosis of depressive episode had higher VHI-10 scores, with an average of 15.7, compared to the rest of the sample, with an average of 11.7 (P = 0.01). No association was found between higher VHI-10 scores and diagnosis of anxiety, though anxiety was the most common comorbidity with depression. An increase in age was also found to correlate with an increase in VHI-10 score, and identifying as Hispanic or Latino was correlated with lower VHI-10 scores.

CONCLUSIONS

Patients with coexisting emotional disturbance and pMTD do not have significantly higher perceived voice handicap than patients with pMTD and no emotional disturbance. Patients with pMTD and a history of depressive episode had greater perceived voice handicap.