Chronic rhinosinusitis symptoms differentially impact the likelihood of major depressive disorders

Abstract

Abstract Objectives The extent to which sinonasal symptoms impact the likelihood of major depressive disorders in chronic rhinosinusitis patients with nasal polyposis (CRSwNP) remains incompletely characterized. In this study, we sought to determine whether individual symptom clusters differentially impact the likelihood of depression in a cohort of CRSwNP patients. Methods We retrospectively included 77 patients with CRSwNP. The severity of sinonasal symptoms was assessed using the 22‐item Sino‐Nasal Outcome Test (SNOT‐22) and grouped according to a previously validated four‐subdomain structure: nasal, otologic/facial pain, sleep, and emotional subdomains. The likelihood of major depressive disorders was assessed using the Patient Health Questionnaire‐2 (PHQ‐2). The clinical characteristic of symptom severity (nasal polyp size) and disease‐specific information, such as the number of previous sinonasal surgeries, were also collected. Results The sleep subdomain was most strongly associated with the likelihood of major depressive disorders, followed by the otologic/facial pain subdomain, after controlling for demographics and clinical indicators of symptom severity (nasal polyp size). We found a SNOT‐22 score ≥ 30.5 to be an accurate indicator of scoring higher than or equal to 2 on the PHQ‐2 in CRSwNP patients. This had a sensitivity of 83.33% and a specificity of 75.47%. Conclusion Distinct sinonasal symptom clusters differentially impact the likelihood of depression in CRSwNP patients. Raising awareness for those with severe sinonasal symptomatology might help identify more patients with a higher probability of comorbid depression. Level of Evidence: 4.

Keywords

• CRS
• chronic rhinosinusitis
• depression
• outcome research
• PROM
• quality of life