تاثير گفتار درماني بر نشانه هاي اضطراب و افسردگي در بيماران دچار اختلالات كاركردي صدا

Effect of Speech Therapy on Anxiety and Depression Symptoms in Patients with Functional Voice Disorders

اختلالات كاركردي صدا جزء شايع ترين اختلالات صدا است. علاوه بر درگيري صدا، بيماران نشانه هاي روانشناختي از قبيل اضطراب و افسردگي را تجربه مي نمايند. موثرترين روش درماني براي اين گونه بيماران گفتاردرماني است. هدف اصلي اين تحقيق اثربخشي صدادرماني بر وضعيت اضطراب و افسردگي بيماران دچار اختلالات كاركردي صدا بود. روش بررسي 60 بيمار مراجعه كننده به درمانگاه گوش و حلق و بيني بيمارستان اميرالمومنين (ع) رشت در محدوده سني 17 تا 65 سال با تشخيص اختلالات كاركردي صدا در كلينيك گفتاردرماني بوسيله دو تست شاخص معلوليت صدا (Voice Handicap Index; VHI) و مقياس اضطراب و افسردگي بيمارستاني (Hospital Anxiety and Depression Scale; HADS) مورد ارزيابي قرار گرفتند. 36 بيمار با بالاترين نمره اضطراب و افسردگي انتخاب شدند و در غالب يك طرح شبه- آزمايشي به طور تصادفي در دو گروه 18 نفر كنترل و 18 نفر آزمايش قرار گرفتند و پس از گفتاردرماني هم از هردو گروه مجددا هر دو تست VHI و مقياس اضطراب و افسردگي گرفته شد. يافته ها گروه آزمايش پس از انجام مداخله، بهبودي معناداري در VHI و نشانه هاي اضطراب و افسردگي پيدا كردند (0/001>p). اما در گروه كنترل نمرات VHI به طور معناداري كاهش يافت (0/008=p) و نشانه هاي اضطراب (0/222=p) و افسردگي (0/213=p) بدون تفاوت معنادار بود. به علاوه پس از انجام مداخله، گروه آزمايش در مقايسه با گروه كنترل داراي نمرات VHI بهتر و نشانه هاي اضطراب و افسردگي كمتر بود (0/001>p) در حالي كه اين تفاوت ها در پيش آزمون معنادار نبود (0/05

Functional voice disorders are among the most prevalent voice disorders. In addition to voice involvement, patients experience psychological symptoms such as anxiety and depression. Speech therapy is the most effective therapy for these patients. The main aim of this study was to determine the effect of speech therapy on anxiety and depression status in patients with functional voice disorder. Methods: Sixty patients (aged between 17 to 65 years), with functional voice disorder, who have referred to the ENT clinic of Amir Almomenin Hospital in Rasht, were investigated using Voice Handicap Index (VHI) and Hospital Anxiety and Depression Scale. Thirty-six patients with the highest anxiety and depression score were selected and randomly divided into two groups of intervention (n=18) and control (n=18) in a form of quasi-experimental design. After speech therapy, both groups were investigated using Voice Handicap Index (VHI) and Hospital Anxiety and Depression Scale again. Results: The experimental group found significant improvement in VHI and symptoms of anxiety and depression after intervention (p<0.001). However in control group, VHI scores were significantly decreased (p=0.008) and anxiety (p=0.222) and depression (p=0.213) were not significantly different. In addition, after the intervention, the experimental group exhibited better VHI scores and less anxiety and depression symptoms compared to the control group (p<0.001). However, these differences were not significant in the pre-test (p>0.05). Conclusion: Speech therapy not only improved the voice status but also significantly reduced the symptoms of anxiety and depression in patients. Speech therapy, through improving the quality of the patient's voice, expands the social, emotional and occupational interactions of the individual and improves the psychological and emotional functioning of patients after passing through the effects of impaired voice.