Unilateral vocal fold paralysis as an independent risk factor for depression: a cross-sectional study using BDI and VHI-10

BACKGROUND: This cross-sectional study investigated psychological profiles and voice characteristics in patients with unilateral vocal fold paralysis (UVFP) and other benign vocal fold disorders.

METHODS: Patients diagnosed between January 2017 and December 2020 completed the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and voice assessments, including the Voice Handicap Index-10 (VHI-10). We compared BDI and BAI scores between groups, explored correlations between BDI and voice parameters, and used logistic regression to identify predictors of moderate-to-severe depression (BDI ≥ 20), adjusting for age, sex, and disease duration.

RESULTS: UVFP patients had significantly higher BDI scores compared to those with other vocal disorders (p < 0.05). In the UVFP group, BDI scores were positively correlated with VHI-10 and selected voice measures. Moderate-to-severe depression was more prevalent among UVFP patients (27% vs. 23.4%), with marginal significance (p = 0.059). Logistic regression identified UVFP as an independent predictor of moderate-to-severe depression (OR = 3.47; 95% CI: 1.14-10.60; p = 0.029), independent of age, sex, and disease duration.

CONCLUSION: UVFP is associated with greater psychological burden and independently predicts moderate-to-severe depression. These findings underscore the need for early psychological screening and comprehensive care in UVFP patients.