PDF(Pubmed)
Abstract：
BACKGROUND: Patients with chronic laryngopharyngeal symptoms, with or without pathologic reflux, frequently have poor response to standard therapies, which may be a result of overlapping cognitive-affective processes. Therefore, the aims of this study included measuring psychosocial distress and laryngeal-specific cognitive distress in patients with chronic laryngopharyngeal symptoms (LPS) as well as comparing these among laryngeal symptomatic patients with and without conclusive gastroesophageal reflux disease (GERD).
METHODS: This prospective, single-center study enrolled adults with chronic LPS from 9/22 to 6/23. Patients completed eight questionnaires on quality of life, symptom burden, and psychosocial distress. The laryngeal cognitive affective tool (LCAT) assessed laryngeal-specific hypervigilance and anxiety; LCAT scores ≥33 were elevated. All patients underwent objective testing with endoscopy and/or ambulatory reflux monitoring and were categorized as proven GERD (GER+) or no proven GERD (GER-).
RESULTS: One hundred twenty-nine patients were included: 66% female, mean age 54.1 (17.5) years, mean BMI 27.6 (6.8) kg/m2, 66% Caucasian, 57% with an elevated LCAT, and 53% GER+. Moderate-to-severe anxiety was found in 39% and moderate-to-severe depression in 19%. An elevated LCAT alone or with an elevated anxiety/depression score was found in 58%. Patient-reported outcomes scores, including LCAT scores (32.9 (13.8) GER- vs. 33.1 (12.6) GER+, p = 0.91), were similar between patients with and without GER+.
CONCLUSIONS: Patients with chronic LPS experience heightened levels of hypervigilance, symptom-specific anxiety, and psychosocial distress, regardless of the presence of pathologic GER.
METHODS: This prospective, single-center study enrolled adults with chronic LPS from 9/22 to 6/23. Patients completed eight questionnaires on quality of life, symptom burden, and psychosocial distress. The laryngeal cognitive affective tool (LCAT) assessed laryngeal-specific hypervigilance and anxiety; LCAT scores ≥33 were elevated. All patients underwent objective testing with endoscopy and/or ambulatory reflux monitoring and were categorized as proven GERD (GER+) or no proven GERD (GER-).
RESULTS: One hundred twenty-nine patients were included: 66% female, mean age 54.1 (17.5) years, mean BMI 27.6 (6.8) kg/m2, 66% Caucasian, 57% with an elevated LCAT, and 53% GER+. Moderate-to-severe anxiety was found in 39% and moderate-to-severe depression in 19%. An elevated LCAT alone or with an elevated anxiety/depression score was found in 58%. Patient-reported outcomes scores, including LCAT scores (32.9 (13.8) GER- vs. 33.1 (12.6) GER+, p = 0.91), were similar between patients with and without GER+.
CONCLUSIONS: Patients with chronic LPS experience heightened levels of hypervigilance, symptom-specific anxiety, and psychosocial distress, regardless of the presence of pathologic GER.
摘要：
背景：慢性咽喉症状患者，有或没有病理性反流，通常对标准疗法反应不佳，这可能是认知情感过程重叠的结果。因此,这项研究的目的包括测量慢性咽喉症状(LPS)患者的心理社会困扰和喉部特异性认知困扰,以及在有或没有确凿的胃食管反流病(GERD)的喉部有症状患者之间进行比较.
方法：这种前瞻性，单中心研究纳入了9/22至6/23的慢性LPS成人患者。患者完成了八份生活质量问卷，症状负担，和心理上的痛苦。喉部认知情感工具（LCAT）评估了喉部特定的过度警惕和焦虑；LCAT评分≥33升高。所有患者均接受内窥镜检查和/或动态反流监测的客观测试，并分为已证实的GERD（GER）或未证实的GERD（GER-）。
结果：包括一百二十九名患者：66％为女性，平均年龄54.1(17.5)岁，平均BMI27.6(6.8)kg/m2，66%高加索人，57%的人LCAT升高，和53%GER+。39%的患者为中度至重度焦虑，19%为中度至重度抑郁。在58％的人中发现单独的LCAT升高或焦虑/抑郁评分升高。患者报告的结果评分，包括LCAT分数（32.9（13.8）GER-vs.33.1（12.6）GER+，p=0.91),有和没有GER+的患者相似。
结论：慢性LPS患者的警惕性增高，症状特异性焦虑，和社会心理困扰，无论是否存在病理性GER。
方法：这种前瞻性，单中心研究纳入了9/22至6/23的慢性LPS成人患者。患者完成了八份生活质量问卷，症状负担，和心理上的痛苦。喉部认知情感工具（LCAT）评估了喉部特定的过度警惕和焦虑；LCAT评分≥33升高。所有患者均接受内窥镜检查和/或动态反流监测的客观测试，并分为已证实的GERD（GER）或未证实的GERD（GER-）。
结果：包括一百二十九名患者：66％为女性，平均年龄54.1(17.5)岁，平均BMI27.6(6.8)kg/m2，66%高加索人，57%的人LCAT升高，和53%GER+。39%的患者为中度至重度焦虑，19%为中度至重度抑郁。在58％的人中发现单独的LCAT升高或焦虑/抑郁评分升高。患者报告的结果评分，包括LCAT分数（32.9（13.8）GER-vs.33.1（12.6）GER+，p=0.91),有和没有GER+的患者相似。
结论：慢性LPS患者的警惕性增高，症状特异性焦虑，和社会心理困扰，无论是否存在病理性GER。
