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Relationship Between Fatigue, Perfectionsism and Functional Dysphonia

by Natasha Mirza, MD •

Do patients with functional dysphonia (FD) experience general fatigue in addition to their voice problems, and is this  associated with perfectionism?

Background: FD refers to any nonorganic voice disorder. In the U.K., this is the most common disorder seen by voice clinicians. It is related to a host of predisposing, precipitating and perpetuating factors in many ways similar to the unexplained symptoms of chronic fatigue syndrome (CFS) and irritable bowel syndrome (IBS).

Study design: Case-control study.

Setting: Teaching hospital in the U.K.

Synopsis: Seventy-five patients and 62 age- and gender-matched controls were recruited. They were asked to take a validated Chalder fatigue questionnaire and were also tested on a Multidimensional Perfectionism Scale. Statistical analysis found that the FD patients had significantly higher fatigue and perfectionism scores.

Bottom line: This is the first study to demonstrate that FD patients are both more fatigued and perfectionist than healthy controls. These findings are similar to the personality types found in CFS and IBS patients. The general health and psychological state of FD patients is critical to their treatment. Voice therapy alone cannot resolve these problems, and treatment should target the causative and perpetuating symptom cluster.

Reference: O’Hara J, Miller T, Carding P, et al. Relationship between fatigue, perfectionsism, and functional dysphonia. Otolaryngol Head Neck Surg. 2011;144(6):921-926.