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 Researchers focused on chronic rhinosinusitis, which happens when
the cavities around the nasal passages are inflamed and swollen for
at least 12 weeks. Symptoms can include facial pain and headaches,
nasal obstruction and an impaired sense of smell.
The condition has long been linked to a lower quality of life and
problems with physical, social, emotional and cognitive functioning,
researchers note in JAMA Otolaryngology Head & Neck Surgery. Even
though depression and anxiety commonly accompany chronic
rhinosinusitis, it's unclear whether the mental health issues
preceded or followed the sinus issues.
Up to 15 percent of adults suffer chronic rhinosinusitis at some
point in time, previous research suggests.
The current study focused on 16,224 South Korean patients treated
for chronic rhinosinusitis from 2002 to 2013 as well as a comparison
group of 32,448 similar people who didn't have this issue. None of
them had a history of depression or anxiety.
During 11 years of follow-up, patients with chronic sinusitis were
over 50 percent more likely to develop depression or anxiety.
"Despite receiving optimal medical and surgical treatment, some
patients with chronic rhinosinusitis have repeated, persistent
symptoms, which make this condition challenging to manage," said
senior study author Dr. Dong-Kyu Kim of Hallym University College of
Medicine in Chuncheon, South Korea.
Patients who also have mental health problems "usually show
significantly worse pain and energy levels, as well as difficulty
with daily activities, than do patients . . . without mental health
problems," Kim said by email.
Everyone with sinusitis in the current study had suffered from the
condition for at least 12 weeks when they were diagnosed.
A subset of the participants - 5,461 patients - had nasal polyps, or
noncancerous growths in the nasal cavity that can cause difficulty
breathing.
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Compared to people without sinus issues, those with chronic
rhinosinusitis and nasal polyps were 41 percent more likely to
develop depression after the sinus issue was diagnosed and 45
percent more likely to develop anxiety, the study found.
People with chronic rhinosinusitis without polyps were 61 percent
more likely to become depressed and 63 percent more likely to
develop anxiety than individuals without sinus problems.
The study can't prove whether chronic rhinosinusitis directly causes
anxiety or depression. The researchers also lacked information about
patients' smoking or alcohol use - which could influence both their
sinus condition and mental health issues - as well as data on the
severity of sinus and mental health problems, which might affect the
connections between the conditions.
It's possible that inflammation in rhinosinusitis leads to the
release of certain neurotransmitters - chemicals that affect brain
function - that may combine with genetics and other factors to cause
psychiatric issues, said Dr. Edward McCoul, director of rhinology
and sinus surgery at the Ochsner Clinic in New Orleans, Louisiana.
"At this time, any connection is speculative and much more study is
needed," McCoul, who wrote a commentary accompanying the study, said
by email.
"We don't want to suggest . . . that if they don't get their sinus
infection treated then they're going to go crazy, McCoul added. "But
. . . chronic rhinosinusitis is a condition that is often
unrecognized by the person who has it - they think they're just
having recurring sinus infections - and so, seeking competent care,
preferably from an otolaryngologist, could lead to sooner diagnosis
and control of the condition."
SOURCE: https://bit.ly/2EQkNBF and https://bit.ly/2TyCvBP JAMA
Otolaryngology Head & Neck Surgery, online February 7, 2019.
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