Personality and psychological distress in dysphonia

Objectives. Personality traits and levels of psychological distress were studied in male and female patients with dysphonia. The contributions of medical referral and dysphonia were examined.

Design. A matched groups design with three control groups was used.

Methods. Seventy people with dysphonia, 30 people attending an otolaryngology clinic, 59 people attending general practice clinics, and 51 healthy people acted as participants. Each completed questionnaires of personality traits, alexithymia, health-related coping strategies, mood (normal and pathological) and the past experience of medically unexplained symptoms.

Results. Women with dysphonia reported more psychological distress (anxiety and depression) and more previously unexplained medical symptoms than either healthy or general practice controls. Men with dysphonia exceeded only healthy controls on these factors. Personality and coping factors in men and women with dysphonia were largely unremarkable, an exception being that women with dysphonia tended to have higher neuroticism scores than general practice attendees.

Conclusions. Dysphonia is associated with psychological distress and a past history of experiencing unexplained medical symptoms. However, these characteristics are shared by general otolaryngology patients. This multiple control group study suggests that the problems of psychological distress may affect medical out-patients in general. Studies of patient samples with medically unexplained symptoms that include only healthy controls or 'organic' out-patient controls may be misleading. The phenomenon of medically unexplained symptoms, including dysphonia, imposes a large time and cost burden on health services and its further investigation would benefit-from a collaboration between health psychologists and liaison psychiatrists.