Mental health burden of empty nose syndrome compared to chronic rhinosinusitis and chronic rhinitis

BACKGROUND

Empty nose syndrome (ENS) is characterized by the paradoxical perception of nasal obstruction despite patent sinonasal anatomy after surgery. We investigated the relationship between ENS, and anxiety, depression, obsessive-compulsive disorder, and somatic symptom disorder (SSD) compared to individuals with chronic rhinitis (CR) and chronic rhinosinusitis (CRS).

METHODS

This cross-sectional survey study compared ENS and CR and CRS patients. A total of 116 patients participated: 58 ENS patients from digital support groups, and 58 CRS and CR patients from tertiary rhinology clinics. Study participants completed four validated surveys: (1) Empty Nose Syndrome 6-Item Questionnaire, (2) Rhinosinusitis Disability Index (RSDI), (3) Obsessive Compulsive Inventory - Revised (OCI-R), and (4) PRIME MD Patient Health Questionnaire (PHQ).

RESULTS

ENS patients exhibited a mean RSDI of 78.6, 95% confidence interval [CI] 72.8-84.5, compared to 25.2, 95% CI 18.6-31.8 for CRS/CR patients (p < 0.0001). This difference was seen across all subdomains. Using the PHQ, 53% of ENS patients met diagnostic thresholds for SSD compared to 14% of CRS patients (p < 0.0001). In relation to obsessive compulsive disorder (OCD), 18.37% of ENS patients compared to 8.62% of CRS/CR patients scored above the diagnostic threshold (>21) on the OCI-R questionnaire (p = 0.159).

CONCLUSION

ENS patients had diminished sinonasal quality of life and a higher prevalence of comorbid anxiety and depression, compared to CR and CRS. ENS patients were more likely to exceed thresholds for OCD and SSD compared to controls. Future studies are needed to assess the role of SSD in ENS to help optimize treatment for these complex patients.

Stress Influences the Effect of Obsessive-Compulsive Symptoms on Emotion Regulation

Obsessive-compulsive disorder (OCD) is associated with emotion regulation impairments, namely the frequent use of maladaptive strategies such as suppression and the decreased use of reappraisal strategies. Additionally, these patients exhibit elevated stress levels. Since stress exposure affects emotion regulation abilities, stress might influence the relationship between obsessive-compulsive symptoms and emotion regulation. In this study, we explored the effects of stress and obsessive-compulsive symptoms on emotion regulation in a sample of healthy and OCD individuals. We used self-reported psychometric scales to measure stress levels, obsessive-compulsive symptoms, and emotion reappraisal and suppression skills. We applied multiple regression and mediation analyses. Our results demonstrated that increased reappraisal scores were associated with higher suppression scores. Additionally, elevated stress values predicted increased scores for suppression and decreased scores for reappraisal. Furthermore, the reappraisal abilities resulted from a combination of a direct effect of obsessive-compulsive symptoms and an indirect effect of obsessive-compulsive symptoms mediated by stress. The reliance on suppression strategies and the difficulty in using reappraisal approaches are explained by stress levels and are not directly explained by obsessive-compulsive symptoms. This study highlights the necessity of targeting stress in current therapy-based treatments for OCD.

Preliminary analyses of psychometric characteristics of the Polish version of the Obsessive-Compulsive Inventory-Revised (OCI-R) in a non-clinical sample

OBJECTIVES

Obsessive-compulsive disorder (OCD) is an anxiety-spectrum disorder that affects 1-2% of the adult population. People with OCD are more likely to report impaired social and occupational functioning. Although effective treatments of the OCD exist, many sufferers from this disorder are continuously misdiagnosed. Therefore, improving the assessment of the OCD remains an important area of scientific research. The main goal of the study is the initial verification of psychometric properties in the Polish version of the Obsessive-Compulsive Inventory-Revised (OCI-R) in a college student sample.

MATERIAL AND METHODS

A group of students completed a battery of measures consisting of obsessive-compulsive symptoms (The OCI-R, The Yale-Brown Obsessive Compulsive Scale), depression (The Beck Depression Inventory) and anxiety trait (The State-Trait Anxiety Inventory).

RESULTS

A confirmatory factor analysis, conducted on data from 334 university students, supported a solid and replicable 6-fold factor structure of the OCI-R. Further analyses on test-retest reliability (following a 1-month interval), convergent and divergent validity of the OCI-R were respectively conducted in a group of 137 students who had completed a battery of measures mentioned above. The results showed adequate testretest reliability for the full scale and subscales cores, high internal consistency and confirmed satisfactory convergent and divergent validity.

CONCLUSIONS

The study constitutes the first phase of work on a Polish version of measurement for obsessive-compulsive symptoms. Satisfactory results obtained in a non-clinical sample allow to recognize this method to be promising for further research. Int J Occup Med Environ Health 2016;29(6):1011-1021.

Validation of the Turkish Version of the Obsessive-Compulsive Inventory-Revised (OCI-R) in Clinical and Non-Clinical Samples

INTRODUCTION

The Obsessive-Compulsive Inventory-Revised (OCI-R) is a widely used self-report instrument developed to overcome the problems with the available instruments. The aim of this study was to assess the psychometric properties of the revised Obsessive Compulsive Inventory (OCI-R) in Turkish sample.

METHODS

The psychometric properties of the Turkish version of the Obsessive-Compulsive Inventory-Revised (OCI-R) were assessed in clinical samples (n=44 for patients with obsessive-compulsive disorder (OCD), and n=44 for patients with major depression (MD) and a non-clinical student sample (n=287).

RESULTS

The confirmatory factor analysis demonstrated that the original six-factor structure was valid in the Turkish sample. The overall and each of the subscales showed moderate to good internal consistency and convergent validity as well as test-retest reliability. However, the Cronbach's alpha was excessively low for the hoarding subscale in the OCD group. The total and subscale scores of the OCI-R satisfied at discriminating patients with OCD from both patients with MD and healthy controls, with an exception of the neutralizing subscale.

CONCLUSION

The Turkish version of the OCI-R did not reveal sound psychometric properties. Findings are discussed in the light of current theoretical considerations.