To examine (i) if depression and anxiety are prospectively associated with subsequent lower urinary tract symptoms (LUTS) and (ii) if LUTS are prospectively associated with subsequent depression.
The study is based on data from parous middle-aged women from the Avon Longitudinal Study of Parents and Children. LUTS were assessed using the Bristol Female LUTS Questionnaire and the International Consultation on Incontinence Questionnaire on Female LUTS. Depression was assessed using the Edinburgh Postnatal Depression Scale and anxiety was assessed using the Crown Crisp Experiential Index. We used multivariable logistic regression to examine (i) associations between depression and anxiety at baseline in 2002-04 and subsequent LUTS at follow-up in 2011-2012 (n = 5291) and (ii) associations between LUTS at baseline in 2002-04 and subsequent depression at follow-up in 2010-11 (n = 6147). Analyses were adjusted for age, socioeconomic factors, stressful life events, social support, smoking, weekly alcohol consumption, BMI, physical activity, obstetric/reproductive factors, and menopausal status.
We found evidence of prospective associations between depression and subsequent mixed urinary incontinence [odds ratio = 1.97, 95 % confidence interval = 1.16, 3.33], any urinary incontinence [1.68 (1.21, 2.31)], and urgency [1.90 (1.28, 2.83)]. Anxiety was only associated with subsequent nocturia [1.84 (1.04, 3.26)]. Only stress urinary incontinence was associated with subsequent depression [1.37 (1.03, 1.83)].
We find evidence that mental health problems could be contributing factors, as well as consequences, of LUTS. Research is needed to determine if these observed associations are causal and to identify underlying mechanisms.
Journal of affective disorders. 2024 Oct 09 [Epub ahead of print]
Carol Joinson, Marcus J Drake, Abigail Fraser, Kate Tilling, Jon Heron
Bristol Medical School, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, United Kingdom of Great Britain and Northern Ireland. Electronic address: ., Department of Surgery and Cancer, Imperial College London, South Kensington Campus, London SW7 2AZ, United Kingdom of Great Britain and Northern Ireland., Bristol Medical School, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom of Great Britain and Northern Ireland., Bristol Medical School, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, United Kingdom of Great Britain and Northern Ireland.