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Does comorbid anxiety predict quality of life outcomes in patients with chronic rhinosinusitis following endoscopic sinus surgery?
Author(s) -
Steele Toby O.,
Mace Jess C.,
Smith Timothy L.
Publication year - 2015
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21543
Subject(s) - medicine , anxiety , quality of life (healthcare) , depression (economics) , chronic rhinosinusitis , comorbidity , diabetes mellitus , sinusitis , physical therapy , psychiatry , surgery , endocrinology , nursing , economics , macroeconomics
Background Approximately 25% of patients with chronic rhinosinusitis (CRS) have comorbid anxiety and both conditions independently decrease quality of life (QOL). QOL outcomes for CRS and depression have garnered the majority of research attention, but efforts to better understand the impact of anxiety disorders on QOL are increasing. We evaluated the role of comorbid anxiety in patients with CRS undergoing endoscopic sinus surgery (ESS). Methods Adult patients (n = 148) with CRS with and without comorbid anxiety were prospectively enrolled into a treatment outcomes investigation. History of comorbid anxiety was retrospectively identified (n = 30; 20%) and preoperative and postoperative QOL (Rhinosinusitis Disability Index [RSDI], and 22‐item Sino‐Nasal Outcome Test [SNOT‐22]) scores were compared to patients without comorbid anxiety. Results Compared to patients without anxiety, patients with anxiety were found to be younger ( p = 0.02) and have a higher prevalence of female gender ( p = 0.05), diabetes mellitus ( p < 0.001), depression ( p < 0.001), and tobacco use ( p = 0.03). Participants with comorbid anxiety reported significantly worse preoperative psychological dysfunction as measured by SNOT‐22 subdomain scores ( p = 0.02), as well as worse preoperative functional ( p = 0.04) and emotional ( p = 0.001) impairment as evaluated by RSDI subdomain scores. After adjustment for other cofactors, patients with anxiety improved significantly less on SNOT‐22 total scores compared to participants without anxiety after ESS ( p = 0.02). Conclusion Anxiety occurs with higher prevalence in patients with CRS and the presence of comorbid anxiety is associated with worse preoperative QOL and reduced QOL improvement following ESS. These findings warrant improvement in screening, diagnosis, and treatment for patients with CRS and comorbid anxiety.