Author(s)
Kaylee Fisher, BA
Nancy M. Bauman, MD, FACS, FAAP
Pamela A. Mudd, MD, MBA, FAAP
Courtney Long, MEd, CCC-SLP, CLC, NTMTC
Hengameh K. Behzadpour, MSHS
Lilia Mucka Andrew, PhD
Affiliation(s)
(1) GW School of Medicine and Health Sciences, Washington, DC
(2) Children's National Hospital, Washington, DC
Abstract:
Background/Objective: To systematically assess anxiety and depression rates in a large cohort of pediatric patients with vocal cord dyskinesia (VCD) using updated validated measures including the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-8 (PHQ-8).
Methods: Review of VCD Questionnaire (VCD-Q), Dyspnea Index (DI), GAD-7 and PHQ-8, in 40 VCD-positive consecutive pediatric patients evaluated from 1/22-7/25 in a multidisciplinary VCD clinic. Intake measures included demographics, VCD Symptom Scale, DI, GAD-7 and PHQ-8. Descriptive statistics and linear regressions were used to analyze associations among psychological and clinical variables
Results: Participants were a mean age of 13.8 years (SD=2.9); 75% were female and 50% were athletes. History, VCD and DI scores were consistent with VCD diagnosis. Mean GAD-7 and PHQ-8 scores were 6.55 (range=0-21;SD=5.28) and 4.9 (range=0-17;SD=5.42) respectively with elevated (scores=5) anxiety and depression scores in 57.5% and 37.5% of patients respectively. GAD-7 and PHQ-8 were strongly correlated (r=.756, p<.001). Multiple linear regression showed PHQ-8 Total was significantly predicted by GAD-7 Total (B=0.554,p<.001), Age (B=0.478,p=.045), and VCD Index total (B=-0.180,p=.041). Non-significant predictors included gender, grade point average (GPA), self-identified stress, and DI. Similarly, GAD-7 total was significantly predicted by PHQ-8 total (B=0.559, p<0.001) and GPA (B=-1.376,p=.034). Non-significant predictors were gender, self-identified stress, age, DI, and VCD Index.
Conclusions: Anxiety and depression are common in pediatric patients with VCD. Although a causal relationship among these associations remains unclear, routine screening for psychological comorbidities is essential to address both physical and emotional components of VCD and optimize management outcomes.