Functional dysphonia: A role for psychologists?

Abstract Functional dysphonia is a relatively common psychosomatic disorder in which patients present with difficulties of voice production, such as hoarseness, huskiness and jerkiness in the absence of a structural or neurological abnormality of the larynx. It remains a diagnosis of exclusion after specialist examination by an otolaryngologist. The aetiology of the disorder has attracted a number of appealing but poorly substantiated psychodynamic theories. There is evidence that the disorder is associated with high neuroticism, anxiety, depression and alexithymia but these findings do not explain why the larynx should be the target organ of this distress. Treatment often involves referral for a course of speech therapy which may include psychological interventions. Because the psychological skills of speech therapists are acquired in a haphazard fashion, it is advocated that clinical psychologists develop a training and consultative role for speech therapy, equipping therapists with additional psychological skills, leading to more effective treatment for patients with functional dysphonia.