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Invited Commentary
February 7, 2019

Does Chronic Rhinosinusitis Lead to Psychiatric Disease?

Author Affiliations
  • 1Department of Otorhinolaryngology, Ochsner Clinic, New Orleans, Louisiana
JAMA Otolaryngol Head Neck Surg. 2019;145(4):319-320. doi:10.1001/jamaoto.2018.4162

The Original Investigation by Kim and colleagues1 in this issue of JAMA Otolaryngology–Head & Neck Surgery investigates the association between chronic rhinosinusitis (CRS) and common psychiatric disorders, a topic that has been often discussed but rarely subjected to large-scale, population-based study.2-4 The investigators used data from a national health service database during an 11-year period to determine the incidence and risk of depression and anxiety in a population with CRS. Building on previous reports of comorbidity prevalence, the investigators found an increased incidence and risk of new diagnoses of both psychiatric conditions. Subgroup analysis according to phenotypic presence or absence of nasal polyps demonstrated greater incidence in the nonpolypoid cohort. Increased prevalence of depression has been previously noted in smaller-scale observational and cross-sectional studies, with a recent systematic review reporting prevalence ranging from 11% to 40%.5 In contrast, the risk of developing anxiety with CRS has not been previously reported. The present findings also indicated an increased risk of psychiatric disease in CRS with polyps, albeit with a less pronounced effect size. These findings suggest that the risk of developing psychiatric disease after a diagnosis of CRS may be elevated across phenotypes and may constitute a clinically important component in the diagnosis and management of the heterogeneous syndrome currently known as CRS.6