Depression Symptoms and Olfactory-related Quality of Life

Abstract

Objectives: Patients with olfactory dysfunction (OD) frequently report symptoms of depression. The objective of this study was to determine how clinical characteristics and olfactory-related quality of life (QoL) measures associate with the likelihood for major depressive disorders (MDDs).

Methods: A total of 192 OD patients were included. Olfactory function was measured using all three subtests of the Sniffn' Sticks test. Olfactory-related quality of life (QoL) was evaluated using the Questionnaires of Olfactory Dysfunction (QOD)-negative (NS) and -positive statement (PS). The likelihood for MDD was assessed using the Patients Health Questionnaire-2 (PHQ-2). Demographics and disease-specific variables (etiology and duration of OD) were collected. Univariate and multivariable analyses were used to associate disease-specific variables and the QOD with the outcome of the PHQ-2. Additionally, the predictive ability of the QOD-NS to predict depressive symptoms was calculated.

Results: In univariate analysis, COVID-19 related smell loss, the QOD-NS, and the QOD-PS were significantly associated with the PHQ-2. In multivariable analyses adjusting for QoL measures, the QOD-NS (ß = 0.532, p < 0.001) and sinonasal OD (compared with postinfectious OD) were significantly associated with the PHQ-2 (ß = 0.146, p = 0.047). When omitting QoL measures from multivariable analyses, only COVID-19 related OD (compared with postinfectious OD) was significantly associated with the PHQ-2 (ß = 0.287, p = 0.009). A QOD-NS score > 20.5 had 70.13% sensitivity and 76.32% specificity for detecting symptoms of depression.

Conclusion: Our results suggest that COVID-19 related OD might be associated with a higher likelihood for MDD. Furthermore, we showed that the QOD-NS score might be helpful to predict symptoms of depression in OD patients.

Level of evidence: 4 Laryngoscope, 132:1829-1834, 2022.

Keywords: PROM; anosmia; depression; hyposmia; olfactory dysfunction; quality of life; smell loss.

Fig. 1

Scattergram (mean ± SD) of the PHQ‐2 score by different reasons for smell loss. Groups were compared by the ANOVA test with post hoc Tukey's test. *p < 0.05. [Color figure can be viewed in the online issue, which is available at www.laryngoscope.com.]

Fig. 2

Receiver operating characteristic curve for the QOD‐NS score as an indicator to score ≥2 on the PHQ‐2. The cutoff of >20.5 (red point) maximizes the sum of sensitivity (70.13%) and specificity (76.32%). [Color figure can be viewed in the online issue, which is available at www.laryngoscope.com.]