Psychological Burden in Subglottic Stenosis: The Prevalence of Depression and Anxiety.

Abstract

<b>Introduction:</b> Subglottic stenosis (SGS) is a rare, recurring fibroinflammatory disease that causes upper airway narrowing and severe dyspnea. Patients often require multiple surgeries due to chronic restenosis. The unpredictable nature of SGS may significantly affect psychological well-being. <br><br><b>Aim:</b> The aim of this study is to determine the prevalence of depression and anxiety in SGS patients and identify associated risk factors. <br><br><b>Materials and methods:</b> A retrospective chart review was conducted of patients diagnosed with SGS at a tertiary care center from 2012 to 2022. Data collected included demographics, SGS etiology, number/type of surgeries, tracheostomy history, pulmonary function tests, medications, and psychiatric history. Statistical analyses included t-tests, chi-square, and ANOVA with Bonferroni correction. <br><br><b>Results:</b> Of 246 patients (mean age 54, body mass index [BMI] 32 8.7), 16% had a clinical diagnosis of depression, and 49% reported a history of anxiety or depression. Patients with psychiatric comorbidities were older (57.7 vs 52.1 years, p<0.05). Intubation was the leading cause of SGS (41.9%) and significantly associated with depression (p = 0.03). Patients with depression had higher rates of hospital admission within a year (p = 0.00). Interestingly, those with mental health hospitalizations were significantly younger (p = 0.01). <br><br><b>Discussion:</b> Depression and anxiety are more prevalent in SGS patients than in the general population. Contributing factors include age, etiology (particularly intubationrelated SGS), and surgical burden. <br><br><b>Conclusions:</b> Mental health should be an integral part of SGS management. Future prospective studies using standardized symptom surveys may better capture the psychological impact of SGS and inform holistic patient care.