Depression and anxiety in chronic rhinosinusitis

Background: Both depression and anxiety have been suspected to impact quality of life adversely in patients with chronic rhinosinusitis (CRS). The objective of this work was to assess for the presence of anxiety and/or depression in the setting of CRS and to assess their impact on disease-related quality of life by analyzing the correlation between the Rhinosinusitis Disability Index (RSDI) and the Hospital Anxiety and Depression score (HADS), as well as the Lund-Kennedy nasal endoscopic scores. Methods: A total of 124 patients with CRS were prospectively evaluated in the outpatient setting using the RSDI and HADS questionnaires as well as the Lund-Kennedy nasal endoscopy scoring system. Results: The total RSDI and its subscale scores had moderate to very strong correlation with the HADS total score and each of its subscale scores in comparison to their poor correlation with Lund-Kennedy endoscopic score. CRS patients with depression or anxiety scores 8 to 10 (possible case of clinically significant depression or anxiety) and 11 to 21 (probable case) reported worse total RSDI and subscale scores when compared with those with normal scores (0 to 7). There was no significant difference in the Lund-Kennedy endoscopic scores between the different groups of anxiety and depression scores. Conclusion: Depression and anxiety are prevalent in CRS. The total RSDI and its different subscale scores exhibit moderate to very strong correlation with depression/anxiety scores as determined by HADS, whereas poor correlation was seen with the Lund-Kennedy endoscopic score.