A national survey identified multiple risk factors for voice disorders among adolescents, with family history emerging as the strongest predictor, making teens more than seven times more likely to experience voice problems.
Medical conditions significantly increased the risk among the 502 US adolescents aged 13 to 17 years studied. Cancer carried the highest odds, followed by diabetes, neurological disorders, and gastrointestinal issues. Acid reflux, asthma, breathing problems, heart problems, speech problems, and swallowing problems also elevated the risk.
Overall, 7.4% of respondents reported current voice problems and 24.3% reported a history of voice issues, according to researchers led by Robert Brinton Fujiki, PhD, CCC-SLP, of Indiana University School of Medicine. About one-third of cases were chronic, lasting longer than four weeks.
Behavioral health conditions were strongly linked to voice disorders. Adolescents with anxiety were more than twice as likely to report problems with risk increasing as anxiety severity worsened. Those with depression had nearly double the odds.
Certain medications tripled the risk. Depression and anxiety medications, as well as steroids, oral contraceptives, or hormones, each carried more than 3 times higher odds. Inhaler use was associated with 60% higher risk.
Chronic cases displayed distinct patterns, with affected adolescents 20 times more likely to report a family history and five times more likely to report heart problems compared with acute cases. They also had higher rates of speech, swallowing, and breathing difficulties, suggesting interconnected system dysfunction.
Participants were recruited through the AmeriSpeak Panel between March and June 2023, with data weighted to match US demographics. The final group (n = 502) included 254 male patients and 248 female patients, with a mean age of 15 years.
Limitations included reliance on self-reported data, broad medical and medication categories, and an observational design that established associations but not causality.
Researchers concluded that voice problem evaluation and management among adolescents should consider medical history, behavioral health, and medication effects alongside vocal symptoms.
Full disclosures can be found in the published study.