Objective: Previous literature has assessed the impact of various disease states on patient-reported vocal fatigue. In this study, we examined the opposite: the effect of patient-reported vocal fatigue on a variety of markers of stress and mental health.

Methods: We surveyed 560 adults via crowdsourced research platforms (Mechanical Turk, CloudResearch Connect) using a range of patient-reported outcome measures (PROMs), including measures of anxiety, depression, sleep quality, substance use, pain interference, and pain intensity. Principal component (PCA) and subsequent regression analyses were performed to determine the percent of variance explained by these factors.

Results: PCA revealed four principal components that together accounted for 59% of the variance of the sample. PC1 was related to pain, poor physical function, reflux symptoms, alcohol consumption, and vocal disability; PC2, to fatigue, sleep quality, anxiety, depression, and personality factors; and PC3, to tobacco and caffeine consumption. Regression findings will be discussed in detail.

Conclusions: Survey results underscored the connections between vocal health and mental health. We urge clinicians and researchers to assess, report, and make appropriate referrals for mental health and stress-related conditions, as they represent potential causes and effects of poor vocal health.