A study from the Massachusetts Eye and Ear Infirmary shows patients with chronic rhinosinusitis, or CRS, and depression are more likely to miss work or school.

CRS is a prevalent chronic illnesses in the United States that causes significant quality of life issues for patients with trouble breathing or sleeping due to obstructed nasal and sinus passages.

Researchers identified depression symptoms as the driving force behind lost days of work or school in patients with CRS.

“In this study, we found that of all symptoms related to CRS — sinus, nasal or otherwise — the severity of depressed mood and depression symptomatology was the predominant factor associated with how often our CRS patients missed work or school due to their CRS,” Dr. Ahmad R. Sedaghat, a sinus surgeon at Massachusetts Eye and Ear and assistant professor of otolaryngology at Harvard Medical School, said in a press release. “The severity of even symptoms most typically related to CRS, such as nasal congestion, was not associated with how often our patients missed work or school due to their CRS.”

Researchers assessed four primary categories of symptoms including sleep disturbances, nasal obstruction, ear and facial pain, and emotional function. Previous studies showed that sleep disturbance and ear and facial pain were most associated with poorer quality of life overall.

Researchers assessed the four categories in 107 patients with CRS and found, on average, patients reported missing three days of work or school in a three-month period, or 12 days a year. They identified emotional symptoms such as depression as the strongest reason for missed days of work or school.

Researchers found no association between sleep disturbances or nasal obstruction symptoms for the cause of missed days of work or school.

“These findings really point to the fact that specific elements [in this case, symptoms] of CRS may be driving specific disease manifestations or consequences of the disease,” Sedaghat said. “In an effort to specifically tailor our CRS treatment to each patient, we have to be cognizant not just of the overall severity of the disease, but also of the severity of individual aspects, symptoms and manifestations of the disease. In this case, we found that depressed mood, which CRS patients commonly experience, is associated with a particular consequence of the disease — that patients may miss work because of CRS — and these results open the door to exploring interventions directed at depressed mood for reducing productivity losses due to CRS.”

The study was published in the Annals of Allergy, Asthma and Immunology.

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