Chronic rhinosinusitis (CRS) patients with depression tend to miss more days of work or school than do CRS patients without depression, according to a new study published in the journal Annals of Allergy, Asthma, and Immunology.
CRS is a chronic illness that can significantly lower the quality of life in affected patients, who often cannot breathe or sleep easily due to obstructed nasal and sinus passages.
The findings show that severity of depression, however, was the primary driver of lost days of productivity in patients with CRS. The study could pave the way for more individualized therapy to help improve the overall quality of life in these patients.
“In this study, we found that of all symptoms related to CRS — sinus, nasal, or otherwise — the severity of depressed mood and depression symptomatology was the predominant factor associated with how often our CRS patients missed work or school due to their CRS,” said senior author Ahmad R. Sedaghat, M.D., Ph.D., a sinus surgeon at Massachusetts Eye and Ear Infirmary and assistant professor of otolaryngology at Harvard Medical School.
“The severity of even symptoms most typically related to CRS, such as nasal congestion, was not associated with how often our patients missed work or school due to their CRS.”
For the study, the researchers focused on four categories of symptoms that characterize CRS — disturbances of sleep, nasal obstruction, ear and facial pain, and emotional function. In other related studies, they found that disturbed sleep and ear/facial pain were most associated with overall poorer quality of life.
In search of a link to lost productivity, the researchers assessed these four categories of symptoms in 107 patients with CRS using a standardized survey. On average, study participants reported three missed days of work or school in a three-month period, or 12 missed days in a year. When the researchers took a closer look at the surveys, they identified emotional symptoms — with depression symptoms being the strongest factor — as the primary driver of missed days of work or school.
The researchers were surprised that there was not an obvious connection between sleep disturbance or nasal obstruction — symptoms which tend to characterize CRS — to patients missing days of work or school.
“These findings really point to the fact that specific elements (in this case, symptoms) of CRS may be driving specific disease manifestations or consequences of the disease,” said Sedaghat.
“In an effort to specifically tailor our CRS treatment to each patient, we have to be cognizant not just of the overall severity of the disease, but also of the severity of individual aspects, symptoms, and manifestations of the disease.”
“In this case, we have found that depressed mood, which CRS patients commonly experience, is associated with a particular consequence of the disease — that patients may miss work because of CRS — and these results open the door to exploring interventions directed at depressed mood for reducing productivity losses due to CRS,” he said.