Journal of Capital Medical University ›› 2026, Vol. 47 ›› Issue (2): 375-381.doi: 10.3969/j.issn.1006-7795.2026.02.020

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Characteristics and influencing factors of neuropsychiatric symptoms in patients with persistent olfactory loss

Yao Linyin1,  Sun Zhifu1,  Guo Yichen1,  Wang Jianhong1,  Gu Qinglong2,  Yi Xiaoli3*   

  1. 1.Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing  100029, China; 2.Department of Otolaryngology Head and Neck Surgery, Capital Center for Childrens Health, Capital Medical University, Beijing  100020, China;3.Department of Radiology, Capital Center for Childrens Health, Capital Medical University, Beijing 100020, China
  • Received:2025-10-15 Revised:2026-02-25 Online:2026-04-21 Published:2026-04-21
  • Supported by:
    This study was supported by Research Foundation of Capital Institute of Pediatrics (JHYJ-2025-02).

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Abstract: Objective  To investigate the prevalence of neuropsychiatric symptoms in patients with persistent olfactory loss (POL) and analyze the influencing factors.Methods  Patients diagnosed with POL at the Smell and Taste Disorder Clinic of Beijing Anzhen Hospital, Capital Medical University, from July 2023 to June 2025 were enrolled. Demographic and clinical data, including age, sex, etiology, and disease duration, were collected. Olfactory function was assessed using the Sniffin' Sticks test, while anxiety and depression were evaluated with the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), respectively. Cognitive function and sleep quality were measured using the Montreal Cognitive Assessment (MoCA) and Pittsburgh Sleep Quality Index (PSQI). All participants underwent structural magnetic resonance imaging scans, and volumes of the bilateral hippocampus and amygdala were extracted using a region of interest (ROI)-based approach. Univariate and multivariate Logistic regression analyses were performed to identify influencing factors, and receiver operating characteristic (ROC) curves were used to evaluate the predictive value of these factors.Results  A total of 84 POL patients were enrolled in the study. The prevalence rates of anxiety, depression, cognitive impairment, and insomnia were 46.43%, 32.14%, 26.19%, and 9.52%, respectively. Univariate analysis revealed that etiology, hippocampal volume, and amygdala volume were significantly associated with the occurrence of neuropsychiatric symptoms (P<0.05). Multivariate Logistic regression analysis indicated that hippocampal volume (OR=0.763, 95% CI=0.622-0.932) and amygdala volume (OR=0.786, 95% CI=0.656-0.979) were protective factors against neuropsychiatric dysfunction in POL patients (P<0.05). The area under the curve (AUC) of ROC analysis showed that both hippocampal volume (AUC=0.874, 95% CI=0.802-0.946) and amygdala volume (AUC=0.912, 95% CI=0.852-0.973) had predictive value for neuropsychiatric symptoms. The combination of these two factors achieved an AUC of 0.944 (95% CI=0.898-0.989), with a sensitivity of 88.9% and specificity of 87.2%.Conclusion  POL patients exhibit a relatively high prevalence of anxiety and depression. Reduced volumes of the hippocampus and amygdala are significant influencing factors for neuropsychiatric symptoms in POL patients. In clinical practice, special attention should be paid to the assessment and follow-up of neuropsychiatric status in POL patients with atrophy of the hippocampus and amygdala.

Key words: olfactory loss, anxiety, depression, magnetic resonance imaging, hippocampus, amygdala

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