Functional Voice Disorders: The Importance of the Psychologist in Clinical Voice Assessment

Abstract

Objectives: The etiopathogenesis of functional voice disorders (FVDs) is multifactorial. The purpose of this study was to analyze the severity of depression and anxiety, and the incidence of affective and anxiety disorders, in patients who presented different types of FVDs and were followed at the University Clinic of Otolaryngology.

Design: This is a cross-sectional study.

Methods: After ENT observation, 83 women were classified into three groups: psychogenic voice disorder (PVD = 39), primary muscle tension voice disorder (MTVD1 = 16), and secondary muscle tension voice disorder (MTVD2 = 28). A psychologist assessed the severity of depression and anxiety using the Hamilton rating scales, and screened for affective and anxiety disorders using the Mini International Neuropsychiatric Interview.

Results: Significant differences in the mean values were found between the groups, with the MTVD1 group having higher levels of depression and anxiety. In affective disorders (current major depression and current mood disorder with psychotic symptoms) and in anxiety disorders (lifetime panic disorder, current generalized anxiety, and current panic disorder with agoraphobia), significant differences in association were found between groups.

Conclusions: Groups presented with significant differences in depression and anxiety levels, and in some psychiatric diagnoses. Patients with FVDs should be independently assessed regarding their voice disorder classification. The integration of a psychologist in the clinical voice assessment team is essential, as findings have corroborated an important incidence of psychiatric disorders in FVDs patients.

Keywords: Functional voice disorders; Primary muscle tension voice disorders; Psychiatric Disorders; Psychogenic voice disorders; Secondary muscle tension voice disorders.