Avaliação multidimensional da voz como método de tomada de decisão na predição de transtornos mentais comuns em pacientes disfônicos

Abstract

Introduction: The scientific literature has pointed out, for years, to the relationship between common mental disorders (CMD) and behavioral dysphonia. However, little has been discussed about the effectiveness of each of the multidimensional voice assessment methods to differentiate the presence of these disorders. Objectives: To develop a decision model to identify the variables that have higher prediction power of the presence of CMD in patients with behavioral dysphonia, as well as present and compare the findings of each stage of multidimensional voice assessment between groups of dysphonic patients with and without CMD. Methodology: Field study carried out at the Speech-Language Therapy School-Clinic of a higher education institution, with 68 patients of both sexes. The volunteers responded to instruments for obtaining information regarding vocal self-assessment and CMD, using the Voice Symptoms Scale, Vocal Handicap Index, Trait-State Anxiety Inventory, BORG-CR10- BR scale and Self-Reporting Questionnaire, which was used to classify them into behavioral dysphonic groups with CMD (CCMD, n = 36) and without CMD (SCMD, n = 32). They were also sent for recording of voice emissions and subsequent auditory perceptual and acoustic analysis, as well as for laryngoscopic and electromyographic exams. Data analysis was performed using descriptive and inferential statistics, using group comparison tests and Weight of Evidence. Results: Dysphonic CCMD show more alterations in the multidimensional evaluation of the voice compared to Dysphonic SCMD, with statistically higher frequency in vocal symptoms of a strained voice, fatigue, shortness of breath and pain when speaking, exposure to a stressful environment, limitation, physical and total domains of VoiSS, BORGCR10- BR scale, electromyographic indices and relative fundamental frequency. The most explanatory variables for the presence of CMD in dysphonic behavioral patients are: BORGCR10- BR scale, Symptoms of itchy throat, fatigue and pain to talk and strained voice, Number of sensorial and total symptoms, Perceptual auditory assessment parameters, Acoustic measures of Jitter, CPPS, GNE, Intensity and fundamental frequency, Electromyographic indices, Female sex, Strait and Trait of Anxiety, Number of personal and total risk factors, Domains of the Voice symptoms scale and Voice Handicap Index. Conclusion: Patients with behavioral dysphonia and common mental disorders have more altered results in all stages of multidimensional voice assessment, compared to dysphonic patients without CMD, with emphasis on the higher prevalence of measures related to phonatory effort.