{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T03:54:19Z","timestamp":1769313259033,"version":"3.49.0"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Teachers are professional voice users. Long\u2010term and intensive voice use, noisy environments, personal factors and occupational stress experienced by these professional voice users may negatively affect vocal health, along with psycho\u2010emotional factors such as depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This cross\u2010sectional and comparative study aimed to compare depressive symptoms between teachers at risk for voice disorders and those without such risk and to examine the relationship between depressive symptoms and voice\u2010related disability levels among teachers at risk for voice disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Procedures<\/jats:title>\n                    <jats:p>A total of 130 teachers were included in this study, comprising 64 participants in the study group and 66 in the control group. The Screening Index for Voice Disorder (SIVD\u2010TR) was used to identify teachers at risk for voice disorders. Based on the SIVD\u2010TR cutoff score, participants were divided into two groups: the study group (SIVD\u2010TR \u2265 4; at risk for voice disorders) and the control group (SIVD\u2010TR &lt; 4; without risk). The Voice Handicap Index (VHI\u201010) was used to assess voice\u2010related disability, and the Center for Epidemiologic Studies Depression Scale (CES\u2010D) was employed to evaluate depressive symptoms and compare them between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes and Results<\/jats:title>\n                    <jats:p>\n                      The mean years of professional experience and the average class size of the study group were higher than those of the control group, and this difference was found to be statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). The mean VHI\u201010 and CES\u2010D scores of the study group were significantly higher compared to the control group (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Among the study group participants, there was a moderate and statistically significant positive correlation between SIVD\u2010TR and VHI\u201010 scores (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.429,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), as well as between VHI\u201010 and CES\u2010D scores (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.413,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001). In addition, a weak but statistically significant positive correlation was observed between SIVD\u2010TR and CES\u2010D scores (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.261,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.037).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Implications<\/jats:title>\n                    <jats:p>It was observed that teachers at risk for voice disorders had longer professional experience and taught in more crowded classrooms. Teachers at risk for voice disorders were found to have significantly higher levels of voice problems and depression symptoms compared to those not at risk. A relationship was identified between the level of voice\u2010related disability and depression symptoms in this population. Early intervention through screening programs may support teachers\u2019 vocal health and psychological well\u2010being. Therefore, it is essential to consider the psycho\u2010emotional state of teachers at risk for voice disorders during the assessment and intervention processes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WHAT THIS PAPER ADDS<\/jats:title>\n                    <jats:p>\n                      <jats:italic>What is already known on the subject<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Teachers are more likely to experience voice problems compared to the general population due to high vocal demands, large class sizes, number of students, classroom noise, insufficient humidity levels and occupational stress.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Voice problems can negatively affect teachers\u2019 professional performance and quality of life.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Additionally, it is known that psycho\u2010emotional conditions such as depression are associated with voice and voice disorders.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                      <jats:italic>What this paper adds to the existing knowledge<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>This study compared depressive symptoms among teachers at risk for voice disorders and those without, and explored the relationship between depressive symptoms and levels of voice\u2010related disability among teachers at risk for voice disorders.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Teachers at risk for voice disorders were found to have significantly higher levels of voice problems and depression symptoms compared to those not at risk.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>A relationship was identified between the level of voice\u2010related disability and depression symptoms in this population.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                      <jats:italic>What are the potential or actual clinical implications of this work?<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>The findings of this study indicate that clinical approaches to teachers\u2019 vocal health should not be limited to vocal function alone.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Professionals working in the field of voice should consider the psychological state of teachers presenting with voice complaints alongside their vocal functioning during assessment and intervention processes.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>This research provides an evidence\u2010based foundation to support multidisciplinary collaboration among speech and language therapists, psychological counsellors, psychiatrists, laryngologists and school administrators.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  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