Neha Thakur, Dinesh Dutt Sharma, Ramesh K Azad, Surbhi Dadwal
Keywords :
Anxiety, Chronic rhinosinusitis, Depression, Mental health
Citation Information :
Thakur N, Sharma DD, Azad RK, Dadwal S. Anxiety and Depression in Chronic Rhinosinusitis. Int J Otorhinolaryngol Clin 2023; 15 (2):76-78.
Introduction: Chronic rhinosinusitis (CRS) is a complex disease that affects not only the nose and sinuses but also has broad effects throughout the body. It is associated with a decreased quality of life, affecting the physical and emotional aspects of daily function, the latter of which could manifest as depression and anxiety. Studies reported depression in 9–25% of CRS patients. Given the negative impact of depression and anxiety on the clinical outcomes of CRS, better screening for undiagnosed depression and anxiety, and improved understanding of the complex interplay between CRS-associated depression and anxiety are needed.
Aim: To find the association of anxiety and depression in chronic rhinosinusitis.
Materials and methods: We assessed 36 CRS patients while comparing them with an equal number of chronic otitis media patients using BAI and BDI-II scores.
Results: The CRS group showed high BAI and BDI-II scores as compared with the control group, but only BDI-II was found statistically significant. Twenty-five percent of CRS cases were suffering with anxiety as compared to 11.1% of control groups. Similarly, 11.1% of CRS had depression as compared with 5.6%.
Conclusion: This is the first Indian study that evaluated mental health problems in CRS patients and found higher BAI and BDI-II scores. These observations require further validation through a large sample study.
Passali D, Passali GC, Piemonte M, et al. The management of chronic rhinosinusitis in clinical practice: An international survey. J Biol Regul Homeost Agents 2021;35(1 Suppl 2):45–50. DOI: 10.23812/21-1supp2-9.
Passali D, Cingi C, Cambi J, et al. A survey on chronic rhinosinusitis: Opinions from experts of 50 countries. Eur Arch Otorhinolaryngol 2016;273(8):2097–2109. DOI: 10.1007/s00405-015-3880-6.
Sundaresan AS, Hirsch AG, Young AJ, et al. Longitudinal evaluation of chronic rhinosinusitis symptoms in a population-based sample. J Allergy Clin Immunol Pract 2018;6(4):1327–1335.e3. DOI: 10.1016/j.jaip.2017.10.012.
Hirsch AG, Stewart WF, Sundaresan AS, et al. Nasal and sinus symptoms and chronic rhinosinusitis in a population-based sample. Allergy 2017;72(2):274–281. DOI: 10.1111/all.13042.
Hastan D, Fokkens WJ, Bachert C, et al. Chronic rhinosinusitis in Europe – An underestimated disease. A GALEN study. Allergy 2011;66(9):1216–1223. DOI: 10.1111/j.1398-9995.2011.02646.x.
Smith KA, Alt JA. The relationship of chronic rhinosinusitis and depression. Curr Opin Otolaryngol Head Neck Surg 2020;28(1):1–5. DOI: 10.1097/MOO.0000000000000595.
Vandelaar LJ, Jiang ZY, Saini A, et al. PHQ-9 and SNOT-22: Elucidating the prevalence of depression in chronic rhinosinusitis. Otolaryngol Head Neck Surg 2020;162(1):142–147. DOI: 10.1177/0194599819886852.
Kim J, Ko I, Kim MS, et al. Association of Chronic Rhinosinusitis With Depression and Anxiety in a Nationwide Insurance Population. JAMA Otolaryngol Head Neck Surg 2019;145(4):313–319. DOI: 10.1001/jamaoto.2018.4103.
Kim JY, Ko I, Kim MS, et al. Relationship of chronic rhinosinusitis with asthma, myocardial infarction, stroke, anxiety, and depression. J Allergy Clin Immunol Pract 2020;8(2):721–727.e3. DOI: 10.1016/j.jaip.2019.09.001.
Gill AS, Levy JM, Wilson M, et al. Diagnosis and management of depression in CRS: A knowledge, attitudes and practices survey. Int Arch Otorhinolaryngol 2021;25(1):e48–e53. DOI: 10.1055/s-0040-1701268.
Adams KN, Schuman TA, Ebert CS, et al. Self-reported anxiety and depression unchanged after endoscopic sinus surgery for chronic rhinosinusitis. Rhinology 2018;56(3):234–240. DOI: 10.4193/Rhin17.238.
Kazi A, West E, Rahman S, et al. Pain catastrophizing and quality of life in adults with chronic rhinosinusitis. Laryngoscope 2021;131(9): 1939–1945. DOI: 10.1002/lary.29405.
Wasan A, Fernandez E, Jamison RN, et al. Association of anxiety and depression with reported disease severity in patients undergoing evaluation for chronic rhinosinusitis. Ann Otol Rhinol Laryngol 2007;116(7):491–497. DOI: 10.1177/000348940711600703.
Van Zele T, Claeys S, Gevaert P, et al. Differentiation of chronic sinus diseases by measurement of inflammatory mediators. Allergy 2006;61(11):1280–1289. DOI: 10.1111/j.1398-9995.2006.01225.x.
Polzehl D, Moeller P, Riechelmann H, et al. Distinct features of chronic rhinosinusitis with and without nasal polyps. Allergy 2006;61(11):1275–1279. DOI: 10.1111/j.1398-9995.2006.01132.x.
Van Bruaene N, Pérez-Novo CA, Basinski TM, et al. T-cell regulation in chronic paranasal sinus disease. J Allergy Clin Immunol 2008;121(6):1435–1441.e1–1441.e3. DOI: 10.1016/j.jaci.2008.02.018.
Nanayakkara JP, Igwe C, Roberts D, et al. The impact of mental health on chronic rhinosinusitis symptom scores. Eur Arch Otorhinolaryngol 2013;270(4):1361–1364. DOI: 10.1007/s00405-012-2230-1.
Tomoum MO, Klattcromwell C, DelSignore A, et al. Depression and anxiety in chronic rhinosinusitis. Int Forum Allergy Rhinol 2015;5(8):674–681. DOI: 10.1002/alr.21528.
Kerner NA, Roose SP. Obstructive sleep apnea is linked to depression and cognitive impairment: Evidence and potential mechanisms. Am J Geriatr Psychiatry 2016;24(6):496–508.
Ranford D, Tornari C, Takhar A, et al. Co-morbid anxiety and depression impacts on the correlation between symptom and radiological severity in patients with chronic rhinosinusitis. Rhinology 2020;58(6):568–573. DOI: 10.4193/Rhin20.075.
Hanna BM, Crump RT, Liu G, et al. Incidence and burden of comorbid pain and depression in patients with chronic rhinosinusitis awaiting endoscopic sinus surgery in Canada. J Otolaryngol Head Neck Surg 2017;46(1):23. DOI: 10.1186/s40463-017-0205-3.
Erskine SE, Hopkins C, Clark A, et al. Chronic rhinosinusitis and mood disturbance. Rhinology 2017;55(2):113–119. DOI: 10.4193/Rhin16.111.
Kara N, Yao AC, Newton J, et al. General illness and psychological factors in patients with chronic nasal symptoms. Clin Otolaryngol 2018;43(2):609–616. DOI: 10.1111/coa.13032.
Schlosser RJ, Storck K, Cortese BM, et al. Depression in chronic rhinosinusitis: A controlled cohort study. Am J Rhinol Allergy 2016;30(2):128–133. DOI: 10.2500/ajra.2016.30.4290.
Vogt F, Sahota J, Bidder T, et al. Chronic rhinosinusitis with and without nasal polyps and asthma: Omalizumab improves residual anxiety but not depression. Clin Transl Allergy 2021;11(1):e12002. DOI: 10.1002/clt2.12002.