Exploring Mental Health in a Pediatric Paradoxical Vocal Fold Motion Sample Using Patient-Reported Outcomes

Otolaryngol Head Neck Surg. 2024 Apr;170(4):1167-1172. doi: 10.1002/ohn.641. Epub 2024 Jan 9.

Abstract

Objective: Paradoxical vocal fold motion (PVFM) is characterized by inappropriate adduction of vocal folds during inspiration causing dyspnea. While anxiety is suspected to be a predisposing factor, incidence has been understudied.

Study designs: Retrospective review.

Setting: Multidisciplinary PVFM hospital clinic.

Methods: We used patient-reported outcome measures to examine anxiety and depression in consecutive patients aged 10 to 17 years using Pediatric SFv1.1 Anxiety 8b and Level 2-Depression inventories (parents completed proxy forms). T-scores were classified as normal (none to slight <55) or elevated (mild 55-59.9, moderate 60-69.9, severe >70).

Results: Twenty-three pediatric patients and 20 parents completed surveys. Mean age was 13.74 years. For anxiety, 69.6% of patients and 40% of parents identified elevated levels. For depression, 30.4% of patients and 15% of parents identified elevated levels. Therapy need for the sample was 65.2% (34.8% active in services and 30.4% referred). Child anxiety scores were significantly higher in the therapy need group, U = 17, P = .004.

Conclusion: This study of adolescents with PVFM confirmed elevated anxiety and depression scores in 2/3 of the participants. Anxiety likely precedes diagnosis and is a predisposing factor. Referral for individualized intervention targeting anxiety and depression is indicated.

Keywords: anxiety; depression; paradoxical motion; pediatric; vocal fold.

MeSH terms

  • Adolescent
  • Child
  • Dyspnea
  • Humans
  • Mental Health*
  • Patient Reported Outcome Measures
  • Vocal Cord Dysfunction*
  • Vocal Cords