Somatization, Depression, and Anxiety Disorders in a Rhinology Practice

Elie S. Alam, Dominique L. Musselman, Darius Chyou, Ghaith Shukri, Corinna G. Levine, Saurin Sanghvi, Hang Zhang, Roy R. Casiano

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Background: Patients present to rhinology clinics with various complaints. Symptoms may be attributable to objective findings, some remain unexplained. The objective is to investigate the incidence of psychological disorders in a rhinologic practice and evaluate a correlation of these psychiatric diseases with rhinologic symptoms. Methods: Patients presenting to a rhinology clinic were administered the Generalized Anxiety Disorder 7 (GAD 7), Patient Health Questionnaire 9 (PHQ 9), and PHQ 15, psychometric instruments that can screen for generalized anxiety, major depression, and somatization disorder, respectively. Patients’ symptoms, endoscopic findings, medication, and psychiatric history were recorded. Multivariable analysis was performed for patients showed moderate-to-severe anxiety, depression, and somatic symptoms via 3 logistic regressions where the outcome was a GAD 7, PHQ 9, or PHQ 15 above 10. Results: One hundred ninety-six patients were included for this study. There were 109 females and 87 males with a mean age of 49 years. Overall, 9%, 14%, and 21% exhibited moderate-to-severe anxiety, depressive, and somatization symptoms, respectively. Nasal obstruction was the only statistically significant variable that increased the odds of having moderate-to-severe anxiety symptoms. Similarly, headache, nasal obstruction, and anosmia/hyposmia were associated with increased odds of having depressive symptoms, and female gender, headache, and nasal discharge increased the odds of somatic symptom disorder. Edema was the only objective endoscopic finding, which was associated with depression only. Conclusions: Patients should be counseled about the pathophysiology and psychiatric comorbidities affecting their primary rhinologic complaints. The provider needs to set realistic treatment expectations in order to achieve the desired clinical outcomes.

Original languageEnglish (US)
Pages (from-to)470-477
Number of pages8
JournalAmerican Journal of Rhinology and Allergy
Volume33
Issue number5
DOIs
StatePublished - Sep 1 2019

Keywords

  • anxiety
  • chronic sinusitis
  • depression
  • facial pressure
  • headaches
  • rhinology
  • somatization
  • symptoms

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

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