ObjectiveThe objective of this study was to determine whether depression and anxiety symptoms affect and confound scoring on the 22‐item Sinonasal Outcome Test (SNOT‐22), a commonly used outcome measure for chronic rhinosinusitis.Study DesignProspective cross‐sectional.SettingTertiary care academic center.Methods240 participants completed the SNOT‐22, from which nasal, sleep, ear/facial pain, and emotional subdomain scores were calculated. They also completed the 8‐item Patient Health Questionnaire (PHQ‐8) as a reflection of depression symptoms and 7‐item Generalized Anxiety Disorder (GAD‐7) questionnaire as a reflection of anxiety symptoms. Correlations were calculated between the 4 SNOT‐22 subdomains and the PHQ‐8 and GAD‐7. Additionally, the predictive ability of subdomains and individual items of the SNOT‐22 to predict depression and anxiety was calculated.ResultsThe SNOT‐22 sleep and emotional subdomains most strongly correlated with the PHQ‐8 and the GAD‐7. The emotional and sleep subdomain scores were predictive of having depression or anxiety. An emotional subdomain score ≥4 had 62.5% sensitivity and 90.1% specificity for detecting depression and 78.8% sensitivity and 88.9% specificity for detecting anxiety. A sleep subdomain score ≥21 had 81.2% sensitivity and 71.4% specificity for detecting depression and 87.9% sensitivity and 68.6% specificity for detecting anxiety. The emotional subdomain item related to sadness and the sleep subdomain items related to functional impairment were most predictive of depression and anxiety.ConclusionThe SNOT‐22 emotional and sleep subdomain scores may be used to predict active depression and anxiety symptoms, especially when items related to sadness or functional impairment are scored with moderate burden.