Effect of Speech Therapy on Anxiety and Depression Symptoms in Patients with Functional Voice Disorders

Document Type : Original Article

Authors

1 Department of Speech Therapy, Tehran University of Welfare & Rehabilitation Sciences, Tehran, Iran

2 Department of Psychology, Faculty of Literature and Humanities, University of Guilan, Rasht, Iran

Abstract

Purpose:
Functional voice disorders are among the most prevalent voice disorders. In addition to voice involvement, patients experience psychological symptoms such as anxiety and depression. Speech therapy is the most effective therapy for these patients. The main aim of this study was to determine the effect of speech therapy on anxiety and depression status in patients with functional voice disorder.
Methods:
Sixty patients (aged between 17 to 65 years), with functional voice disorder, who have referred to the ENT clinic of Amir Almomenin Hospital in Rasht, were investigated using Voice Handicap Index (VHI) and Hospital Anxiety and Depression Scale. Thirty-six patients with the highest anxiety and depression score were selected and randomly divided into two groups of intervention (n=18) and control (n=18) in a form of quasi-experimental design. After speech therapy, both groups were investigated using Voice Handicap Index (VHI) and Hospital Anxiety and Depression Scale again.
Results: 
The experimental group found significant improvement in VHI and symptoms of anxiety and depression after intervention (p<0.001). However in control group, VHI scores were significantly decreased (p=0.008) and anxiety (p=0.222) and depression (p=0.213) were not significantly different. In addition, after the intervention, the experimental group exhibited better VHI scores and less anxiety and depression symptoms compared to the control group (p<0.001). However, these differences were not significant in the pre-test (p>0.05).
Conclusion:
Speech therapy not only improved the voice status but also significantly reduced the symptoms of anxiety and depression in patients. Speech therapy, through improving the quality of the patient's voice, expands the social, emotional and occupational interactions of the individual and improves the psychological and emotional functioning of patients after passing through the effects of impaired voice.

Keywords

References

  1. Colton R H, Casper J K, Leonard R. Understanding Voice Problems: A physiological perspective for diagnosis and treatment (4 th ed.). Philadelphia: Lippincott Williams & Wilkins; 2011: 321-372.
  2. Boone DR, McFarlane SC, Von Berg shL.Voice and voice therapy. 7th ed. Boston: Allyn & Bacon; 2005.
  3. McFarlane SC, Watterson TL. Vocal nodules: endoscopic study of their variations and treatment. Seminars in Speech and Language 1990;11:47‐59.
  4. Aronson AE, Bless DM. Voice disorders of structural origin. Clinical Voice Disorders. 4th ed. New York: Thieme Med Pub 2009: 24-38.
  5. Masson ML, Ferrite S, Pereira LM, Ferreira LP, Araújo TM. Seeking the recognition of voice disorder as work-related disease: historical-political movement. Ciencia & saude coletiva. 2019; 24(3): 805-816.
  6. American Speech-Language-Hearing Association. Definitions of Communication Disorders and Variations. Available at: http://www.asha. org/policy/ RP1993-00208/. Accessed February 18, 2018
  7. Harris S. When it isn't just physical: The effects of stress and emotion on the voice. [Internet].  British Voice Association; 2019 [Cited 2019 Sep 13]. Available from: https://www. British voice association .org.uk/voicecare_stress-emotion-voice.htm.
  8. Martinez CC, Cassol M. Measurement of voice quality, anxiety and depression symptoms after speech therapy. Journal of Voice. 2015 Jul 1;29(4):446-449.
  9. Vertanen-Greis H, Löyttyniemi E, Uitti J. Voice Disorders Are Associated with Stress Among Teachers: A Cross-Sectional Study in Finland. Journal of Voice 2020; 34(3): 488.e1-488.e8.
  10. Lortie CL, Thibeault M, Guitton MJ, Tremblay P. Effects of age on the amplitude, frequency and perceived quality of voice. Age 2015; 37(6): 117.
  11. Tezcaner ZÇ, Gökmen MF, Yıldırım S, Dursun G. Clinical Features of Psychogenic Voice Disorder and the Efficiency of Voice Therapy and Psychological Evaluation. Journal of Voice [Internet]. Elsevier BV; 2019; 33(2): 250-254.
  12. Andrea M, Andrea M, Figueira ML. Self-perception of quality of life in patients with functional voice disorders: the effects of psychological and vocal acoustic variables. European Archives of Oto-Rhino-Laryngology 2018; 275(11): 2745-2754.
  13. Alva A, Machado M, Bhojwani K, et al. Study of Risk Factors for Development of Voice Disorders and its Impact on the Quality of Life of School Teachers in Mangalore, India. Journal of clinical and diagnostic research: JCDR 2017; 11(1): MC01-5.
  14. Brown O. Discover your voice: how to develop healthy voice habits. Cengage Learning; 1996.
  15. Dietrich M, Abbott KV, Gartner-Schmidt J, Rosen CA. The frequency of perceived stress, anxiety, and depression in patients with common pathologies affecting voice. Journal of Voice 2008; 22(4): 472-488. 
  16. Marmor S, Horvath KJ, Lim KO, Misono S. Voice problems and depression among adults in the United States. The Laryngoscope 2016; 126(8): 1859-1864.
  17. Faul F, Erdfelder E, Lang AG, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods 2007;39(2):175-91.
  18. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta psychiatrica scandinavica 1983; 67(6): 361-370.
  19. Kaviani H, Seyfourian H, Sharifi V, Ebrahimkhani N. Reliability and validity of anxiety and depression hospital scales (HADS): Iranian patients with anxiety and depression disorders. Tehran University Medical Journal. 2009;67(5):379-385. [Persian]
  20. Mojiri F, Rezaei F, Zibaei F, Mohammadi M. Investigating the relationship between the VHI scores and the acoustic parameters in patients suffering from voice disorder. J Res Rehabil Sci 2013; 8(7): 1204-1212. [Persian]
  21. Behrman A, Haskell J. Exercises for Voice Therapy. San Diego, CA: Plural Publishing; 2008.
Journal of Paramedical Sciences & Rehabilitation
Volume 9, Issue 2
August 2020
Pages 50-63

Files

Share

How to cite

Statistics