EMOTIONAL SYMPTOMS ARE SECONDARY TO THE VOICE DISORDER IN PATIENTS WITH SPASMODIC DYSPHONIA

The aims of this study were to evaluate the emotional status and life duality of the patients with spasmodic dysphonia (SD) before and after botulinum toxin treatment, and to ascertain whether SD is a somatofor m disorder. Ten patients with spasmodic dysphonia were injected unilat erally into the vocal cord with botulinum toxin. Before botulinum toxi n treatment, two clinician's rating scales-Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HARS), and three self- rating psychometrics-Zung's Self-Rating Depression Scale (SDS), Life Q uality Scale (GHQ/QL-12), and Symptom Distress Checklist (SCL-90) were applied. Self-rating scales were also administered in 20 matched norm al controls. The patients were reevaluated 1 month after botulinum tox in treatment. The Clinical Global Impression Scale (CGI) was also rate d by the patients themselves and a speech pathologist, The mean scores of SD patients were significantly higher than that of controls in SDS , and subscales of somatization, obsessive-compulsive symptoms, depres sion, anxiety, and psychoticism in SCL-90. The mean scole of GHQ/QL-12 tons significantly higher in the control group. The scores of HDRS, S DS, GHQ/QL-12 and subscales of somatization, depression, and anxiety i n SCL-90 showed significant improvement after botulinum treatment, In CGI, seven patients were rated as improved by patients themselves and the speech pathologist. The patients with SD had more anxiety, depress ion and somatization symptoms, and poor life quality than normal contr ols. Their emotional status and life quality improved after botulinum toxin treatment. The results suggest that the emotional symptoms of pa tients with SD are mainly secondary to voice disorder. (C) 1998 Elsevi er Science Inc.