European Archives of Oto-Rhino-Laryngology

, Volume 275, Issue 11, pp 2745–2754 | Cite as

Self-perception of quality of life in patients with functional voice disorders: the effects of psychological and vocal acoustic variables

  • Mafalda AndreaEmail author
  • Mario Andrea
  • Maria Luísa Figueira



Functional voice disorders (FVD) are multifactorial and may have a significant impact on the patients’ quality of life (QOL). The aim of this study was to explore and analyze the relationship between the VHI scores, psychological variables, and objective voice measurements, and to develop a psychological and/or vocal acoustic model for the overall self-perceived evaluation of quality of life for three different types of FVD.


After ENT examination, 83 women were classified into three groups: psychogenic voice disorder (PVD = 39), primary muscle tension voice disorder (MTVD1 = 16), and secondary muscle tension voice disorder (MTVD2 = 28). All patients were evaluated according to a multidisciplinary assessment protocol, which included the self-evaluation of quality of life (Voice Handicap Index, VHI), psychological evaluation (Hamilton Rating Scales for Depression (HAM-D) and for Anxiety (HARS), and Temperament Evaluation of Memphis, Pisa, Paris and San Diego—Auto questionnaire (TEMPS-A)), and vocal acoustic analysis [mean fundamental frequency (F0, Hz), jitter (local, %), shimmer (local, %), and harmonic-to-noise ratio (HNR, dB)].


Our findings revealed a moderate impact on QOL, regardless of the type of FVD. There were significant correlations between VHI scores, psychological variables, and voice perturbation parameters, with the exception of the MTVD1 and MTVD2 groups. The stepwise multiple linear regression analysis suggested that QOL could be explained by: anxious temperament together with shimmer in PVD group, jitter in the MTVD1 group, and depressive temperament in the MTVD2 group.


Affective temperaments and/or voice perturbation parameters were meaningful predictors of self-evaluation of quality of life in patients with different types of FVD.


Functional voice disorders Voice Handicap Index Psychological evaluation Affective temperaments Voice perturbation parameters 



We thank Mariana Moldão, speech therapist, for her great contribution to the vocal acoustic analysis.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PsychiatrySanta Maria HospitalLisbonPortugal
  2. 2.University Clinic of Otolaryngology, Faculty of MedicineUniversity of LisbonLisbonPortugal
  3. 3.University Clinic of Psychiatric and Medical Psychology, Faculty of MedicineUniversity of LisbonLisbonPortugal

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