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Improvement of Paradoxical Vocal Cord Dysfunction With Integrated Psychiatric Care

Received October 28, 2007; revised January 30, 2008; accepted February 5, 2008. From the Dept. of Psychiatry, Univ. of Iowa Hospitals and Clinics, Iowa City, IA. Send correspondence and reprint requests to Nicole Thurston, M.D., 413 N. Allumbaugh, Suite 101, Boise, ID 83704. e-mail: drnicolethurston{at}gmail.com
© 2009 The Academy of Psychosomatic Medicine

BACKGROUND: Paradoxical vocal cord dysfunction is associated with a high rate of psychiatric comorbidities, including mood, anxiety, somatoform, and personality disorders, and psychosocial distress. OBJECTIVE: The authors draw attention to this disorder because delayed diagnosis and misdiagnosis are common and can contribute to excessive morbidity. METHOD: The authors present a case of paradoxical vocal cord dysfunction. RESULTS: The condition improved dramatically with integrated psychopharmacologic and psychotherapeutic intervention. CONCLUSION: Integrated medication management and psychotherapy by a single psychiatrist-provider with relevant medical understanding can achieve a better alliance between patient and physician and, thus, improved outcomes.

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