Anxiety and Depression Features in Laryngopharyngeal Reflux Disease: A Systematic Review.

Objective: To investigate the anxiety and depression features in laryngopharyngeal reflux disease (LPRD).

Methods: A laryngologist and librarian conducted a PubMed, Scopus, and Cochrane Library systematic review related to anxiety, depression, and mental health in LPRD through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements.

Results: Of the 96 identified studies, 22 publications met the inclusion criteria, accounting for 2162 patients with suspected LPRD (n = 1607), gastroesophageal reflux disease (GERD; n = 423), both LPRD and GERD (n = 132), and 926 healthy/asymptomatic individuals. The LPRD diagnosis was mainly based on symptoms and findings. Twenty-six different mental health instruments were used across the studies. Anxiety was found in 28.8%-39.3% of patients with suspected LPRD. Depression was documented in 6.3%-45.6% of suspected LPRD. Most studies reported a significantly higher prevalence/incidence of anxiety and depression in suspected LPRD compared to controls. The LPRD symptom severity was associated with the severity of anxiety and depression in all studies exploring association findings. The anxiety and depression symptoms were reported as higher in LPRD compared to GERD populations. The bias analysis highlighted an important heterogeneity between studies, especially for the LPRD diagnosis and the mental health instruments used.

Conclusion: The prevalence of depression and anxiety is commonly higher in suspected LPRD compared to asymptomatic individuals. Future studies are needed to understand the association between the development of LPRD and mental health disorders.