Open-access Dysphonia coping strategies, vocal handicap and anxiety/depression symptoms in pre and post-thyroidectomy patients

ABSTRACT

Purpose  To analyze coping strategies for dysphonia, vocal handicap, and anxiety/depression symptoms in patients undergoing thyroidectomy.

Methods  A retrospective study with patients evaluated preoperatively, recently postoperatively, and three months post-thyroidectomy. Data from the Brazilian version of the Voice Disability Coping Questionnaire (B-VDCQ), Vocal Handicap Index (VHI), and Hospital Anxiety and Depression Scale (HADS) were analyzed. Patients with language, neurological, laryngeal, thyroid hormonal, or reflux disorders were excluded.

Results  A total of 20 patients participated (mean age 54 years, SD±16.9), predominantly female (n=17; 85%), with partial thyroidectomy (n=14; 70%). In B-VDCQ, scores decreased between preoperative, recent postoperative, and three-month postoperative assessments, especially in the emotional focus domain, with no significant differences over time. In VHI, the organic domain had the highest scores, indicating mild vocal handicap without differences across assessments. In HADS, mild anxiety traits were observed preoperatively, reduced shortly after surgery, but increased after three months, while depression remained within normal limits. Preoperatively, a moderate positive correlation was found between depression and the organic and total VHI domains. In the recent postoperative period, anxiety showed a weak/moderate positive correlation with B-VDCQ and VHI. After three months, B-VDCQ had a moderate positive correlation with anxiety and total HADS, and a weak correlation between the "functional" and "organic" VHI domains and depression.

Conclusion  Patients primarily use emotion-focused coping strategies, self-report mild vocal handicap, and exhibit mild anxiety traits preoperatively, which decrease postoperatively but increase after three months. The strongest correlations occurred in the immediate postoperative period.

Keywords:
Anxiety; Depression; Dysphonia; Thyroidectomy; Voice

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