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Longitudinal improvement in nasal obstruction symptoms of chronic rhinosinusitis directly associates with improvement in mood

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

The effects of nasal obstruction in patients with chronic rhinosinusitis (CRS) are associated with depressed mood. We sought to validate this finding by determining whether improvement in nasal obstruction would translate to improvement in depressed mood.

Methods

This was a prospective observational study of 150 patients undergoing medical management for CRS. Data were collected at two timepoints: enrollment and a subsequent follow-up visit 3–12 months later. Impact of nasal obstruction was measured using the Nasal Obstruction Symptom Evaluation (NOSE) instrument and depressed mood was measured using the 2-item Patient Health Questionnaire (PHQ-2). Sinonasal symptoms associated with CRS were also measured using the 22-item Sinonasal Outcome Test (SNOT-22). Clinical and demographic characteristics were collected. The relationship between changes in PHQ-2 and NOSE scores was determined with correlation and linear regression.

Results

Change in PHQ-2 score was significantly correlated with change in NOSE score (ρ = 0.30, p < 0.001). After controlling for covariates, change in PHQ-2 score was associated with change in NOSE score (adjusted linear regression coefficient [β] = 0.014, 95% CI 0.006–0.022, p = 0.001). We confirmed these relationships, finding that change in PHQ-2 was associated (adjusted β  = 0.037, 95% CI 0.013–0.061, p = 0.003) with change in the nasal subdomain score of the SNOT-22. Improvement in NOSE score by greater than 22 points was predictive of improvement in PHQ-2 score with sensitivity 54.5% and 83.8% specificity (p < 0.001).

Conclusion

These results provide evidence that improvements in nasal manifestations/symptoms of CRS translate to significant improvements in mood.

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Author information

Authors and Affiliations

  1. Klinik für Hals-, Nasen-, Ohren- Krankheiten, Hals-und Gesichtschirurgie, Kantonsspital Aarau, Aarau, Switzerland

    Marlene M. Speth

  2. Department of Otolaryngology, Harvard Medical School, Boston, MA, USA

    Katie M. Phillips, David S. Caradonna & Stacey T. Gray

  3. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA

    Katie M. Phillips & Stacey T. Gray

  4. Edward Via College of Osteopathic Medicine - Carolinas Campus, Spartanburg, SC, USA

    Lloyd P. Hoehle

  5. Division of Otolaryngology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    David S. Caradonna

  6. Department of Otolaryngology, Head and Neck Surgery, University of Cincinnati College of Medicine, Medical Sciences Building Room 6410, 231 Albert Sabin Way, Cincinnati, OH, 45267-0528, USA

    Ahmad R. Sedaghat

Authors
  1. Marlene M. Speth
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  2. Katie M. Phillips
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  3. Lloyd P. Hoehle
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  4. David S. Caradonna
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  5. Stacey T. Gray
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  6. Ahmad R. Sedaghat
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Corresponding author

Correspondence to Ahmad R. Sedaghat.

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This study and its design were approved by the institutional human studies committee.

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All patients provided informed consent.

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Speth, M.M., Phillips, K.M., Hoehle, L.P. et al. Longitudinal improvement in nasal obstruction symptoms of chronic rhinosinusitis directly associates with improvement in mood. Eur Arch Otorhinolaryngol 276, 2827–2833 (2019). https://doi.org/10.1007/s00405-019-05569-4

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  • DOI: https://doi.org/10.1007/s00405-019-05569-4

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