Patients with chronic rhinosinusitis are at a significantly increased risk of developing anxiety and depression, according to a new study. The study also revealed a bidirectional association, with patients with anxiety and depression showing a heightened risk of developing chronic rhinosinusitis.

The study, published in JAMA Otolaryngology–Head & Neck Surgery, suggested that inflammation, sleep disturbances, and decreased quality of life may play a role. Patients with CRS often experience olfactory dysfunction and diminished productivity, which may exacerbate mental health issues. Sleep disturbances, common in chronic rhinosinusitis (CRS) patients, are also associated with an increased risk of anxiety and depression.

The retrospective cohort study, conducted using data from the National Institutes of Health’s All of Us research program, analyzed 33,732 patients, including 5,622 diagnosed with CRS and 28,110 matched controls. The study’s population included underrepresented racial and socioeconomic groups, enhancing the applicability of the findings. Propensity score matching (1:5) was employed to control for variables such as age, sex, race, and household income, with data collected between January 1, 2008, and December 31, 2018. Among the participants, 69.3% were female, 77.2% were White, 17.9% Black or African American, 1.5% Asian, and 1.7% identified as multiracial.

Patients with CRS had an elevated risk of developing anxiety (hazard ratio [HR], 2.79; 95% confidence interval [CI], 2.47-3.15) and depression (HR, 1.40; 95% CI, 1.27-1.55) compared with controls. Conversely, patients with anxiety (HR, 2.37; 95% CI, 2.18-2.57) and depression (HR, 1.59; 95% CI, 1.46-1.72) were more likely to develop CRS. The odds ratios (OR) further confirmed these associations, with CRS patients being 4.39 times more likely to have anxiety (OR, 4.39; 95% CI, 3.95-4.87) and twice as likely to have depression (OR, 2.04; 95% CI, 1.86-2.24).

Patients with CRS also showed higher rates of comorbidities, including asthma, allergic rhinitis, chronic obstructive pulmonary disease, and sleep disorders like dyssomnia. Female patients and those with an income below $25,000 were more likely to develop anxiety and depression, underlining the need for careful screening in these populations.

Full disclosures can be found in the published study.