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J Allergy Clin Immunol Pract. 2018 Nov - Dec;6(6):2098-2105. doi: 10.1016/j.jaip.2018.04.034. Epub 2018 May 8.

Depressed Mood Modulates Impact of Chronic Rhinosinusitis Symptoms on Quality of Life.

Author information

1
Wayne State University School of Medicine, Detroit, Mich; Department of Otolaryngology, Harvard Medical School, Boston, Mass; Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Mass.
2
Department of Otolaryngology, Harvard Medical School, Boston, Mass; Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Mass.
3
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
4
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Mass; Division of Otolaryngology, Beth Israel Deaconess Medical Center, Boston, Mass.
5
Department of Otolaryngology, Harvard Medical School, Boston, Mass; Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Mass; Division of Otolaryngology, Beth Israel Deaconess Medical Center, Boston, Mass; Department of Otolaryngology and Communications Enhancement, Boston Children's Hospital, Boston, Mass. Electronic address: ahmad_sedaghat@meei.harvard.edu.

Abstract

BACKGROUND:

It is unknown how severity of depressed mood affects the well-recognized relationship between chronic rhinosinusitis (CRS) symptom burden and decreased general health-related quality of life (QOL).

OBJECTIVE:

The objective of this study was to determine whether depressed mood would affect the relationship between CRS symptom burden and decreased general health-related QOL.

METHODS:

For this cross-sectional study, 610 participants with CRS were prospectively recruited. CRS symptom burden was measured with the 22-item Sino-Nasal Outcome Test (SNOT-22). General health-related QOL was measured with the EuroQol 5-dimensional health utility value (EQ-5D HUV) and visual analog scale (EQ-5D VAS). Depressed mood was measured using the Patient Health Questionnaire-2 (PHQ-2). Participants were stratified as having well-controlled CRS symptoms (SNOT-22 < 35) and poorly controlled CRS symptoms (SNOT-22 ≥ 35). Good general health-related QOL was determined as EQ-5D HUV ≥ 0.9 or EQ-5D VAS ≥ 80, in contrast to low general health-related QOL.

RESULTS:

In participants with well-controlled CRS symptoms, both SNOT-22 and PHQ-2 were significantly and negatively associated with good general health-related QOL (P < .020 in all cases using multivariable regression). In participants with poorly controlled CRS symptoms, the PHQ-2 was significantly and negatively associated with good general health-related QOL using the EQ-5D HUV (adjusted odds ratio [OR] = 0.37, 95% confidence interval [CI]: 0.22-0.62, P < .001) or the EQ-5D VAS (adjusted OR = 0.74, 95% CI: 0.57-0.96, P = .024). In contrast, SNOT-22 was not associated with general health-related QOL in these patients.

CONCLUSIONS:

Depressed mood modulates the association between CRS symptom burden and general health-related QOL. Our results suggest a threshold of CRS symptom burden or control, beyond which depressed mood-not CRS symptom burden-drives the association with general health-related QOL.

KEYWORDS:

Chronic rhinosinusitis; Depressed; Depression; EQ-5D; Mood; Quality of life

PMID:
29751155
DOI:
10.1016/j.jaip.2018.04.034

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