Main Article Content
Introduction: Lower urinary tract symptoms (LUTS) refer to a group of medical symptoms with the prevalence of 62.5% in men and 66.6% in women. LUTS (Lower Urinary Tract Symptoms) was associated with increased risk of having clinically relevant depressive symptoms or depression and vice versa. We assumed that patients with chronic lower urinary tract symptoms who referred to urology clinic and have negative urologic evaluations, may suffer from psychological symptoms such as anxiety, depression or obsession.
Methods and Materials: This was a cross-sectional, single group survey of women living in Tehran province. Patients who were suffering from lower urinary tract symptoms for over than 6 months, were included in the study. We evaluate the presence of LUTS by asking the patients about their problems of urinary tract in two major categories: Filling or irritative symptoms - e.g. frequency, urgency, dysuria, nocturia, stress incontinence, urge incontinence. Chi square and independent T tests were used to evaluate the correlation between study variables. All statistical analysis was performed using SPSS software version 16.
Results: There was a positive correlation between irritative symptoms and depression symptoms (p‹0.001) and a negative correlation between obstructive symptoms and depression (p‹0.001). There was no association between LUTS and symptoms of OCD (Obsessive- Compulsive disorder). The mean age of participants with positive BDI (Beck depression inventory) was higher than those with negative BDI. (p= 0.007).
Discussion: The results of this study emphasized the important association of LUTS and depression. In conclusion, depressive disorder can increase the risk of developing LUTS or accelerate this process. So when a patient with either urinary or depression symptoms referred to a psychiatry center, he should be screened for the other disease. This requires an adequate interaction between urology and psychiatry departments to achieve.
Litman HJ, McKinlay JB. The future magnitude of urological symptoms in the USA: Projections using the Boston Area Community Health Survey. BJU Int. 2007; 100:820–5.
Sherwood A, Blumenthal JA, Trivedi R, Johnson KS, O’Connor CM, et al. Relationship of depression to death or hospitalization in patients with heart failure. Arch Intern Med. 2007;167:367–373.
Sundquist J, Li X, Johansson SE, Sundquist K. Depression as a predictor of hospitalization due to coronary heart disease. Am J Prev Med. 2005;29:428–433.
Bula CJ, Wietlisbach V, Burnand B, Yersin B. Depressive symptoms as a predictor of a 6 month outcomes and services utilization in elderly medical inpatients. Arch Intern Med. 2001;161:2609015.
Ayuso-Mateos JL, V á zquez-Barquero JL, Dowrick C, et al. Depressive disorders in Europe: Prevalence figures from the ODIN study . Br J Psychiatry. 2001;179:308–16.
Rutter M, Maughan B. Psychosocial adversities in childhood and adult psychopathology. J Personal Disord. 1997; 11:4–18.
Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593–602.
Michaud CM, Murray CJ, Bloom BR. Burden of disease – implications for future research . J AMA. 2001;285:535–9.
Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007;370:851–8.
Zorn BH, Montgomery H, Pieper K, Gray M, Steers WD. Urinary incontinence and depression. J Urol. 1999;162:82–4.
Melville JL, Fan MY, Rau H, Nygaard IE, Katon WJ. Major depression and urinary incontinence in women: Temporal associations in an epidemiologic sample. Am J Obstet Gynecol. 2009;201:490:e1–7.
Angell J, Bryant M, Tu H, Goodman M, Pattaras J, Ogan K. Association of Depression and Urolithiasis. Urology. 2012; 79:518–25.
Hyman S, Chisolm D, Kessler R, Patel V, Whiteford H. Mental disorders . In Jamison DT, Mosley WH, Bobadilla JL , Measham AR eds, Disease Control Priorities in Developing Countries, 2nd editon. New York: Oxford University Press, 2006;605– 25.
Ayuso-Mateos JL, V á zquez-Barquero JL, Dowrick C, et al. Depressive disorders in Europe: prevalence figures from the ODIN study. Br J Psychiatry. 2001;179:308–16.
Zorn BH, Montgomery H, Pieper K ,Gray M, Steers WD. Urinary incontinence and depression. J Urol. 1999;162:82–4.
Melville JL, Fan MY, Rau H, Nygaard IE, Katon WJ. Major depression and urinary incontinence in women: Temporal associations in anepidemiologic sample. Am J Obstet Gynecol. 2009;201:490;1– 7.
Milsom I, Kaplan SA, Coyne KS, Sexton CC, Kopp ZS. Effect of bothersome overactive bladder symptoms on health-related quality of life, anxiety, depression, and treatment seeking in the United States: Results from EpiLUTS. Urology. 2012;80(1):90–6.
Coyne KS, Kvasz M, Ireland AM, Milsom I, Kopp ZS, Chapple CR. Urinary incontinence and its relationship to mental health and health-related quality of life in men and women in Sweden, the United Kingdom, and the United States. Eur Urol. 2012;61(1):88–95.
Breyer BN, Kenfield SA, Blaschko SD, Erickson BA. The association of lower urinary tract symptoms, depression and suicidal ideation: Data from the 2005–2006 and 2007–2008 National Health and Nutrition Examination Survey. J Urol. 2014; 191(5):1333–9.
Wong SY, Hong A, Leung J, Kwok T, Leung PC, Woo J. Lower urinary tract symptoms and depressive symptoms in elderly men. J Affect Disord. 2006;96:83– 8.
Johnson TV, Abbasi A, Ehrlich SS ,Kleris RS, Raison CL, Master VA .Nocturia associated with depressive symptoms. U rology. 2011;77:183–186.
Eckhardt MD, Van Venrooij GE, Van Melick HH, Boon TA. Prevalence and bother someness of lower urinary tract symptoms in benign prostatic hyperplasia and their impact on well-being. J Urol. 2001;166:563–8.
Gannon K, Glover L, O’ Neill M , Emberton M. Lower urinary tract symptoms in men: self-perceptions and the concept of bother. BJU Int. 2005;96:823-7.
Glover L, Gannon K, McLoughlin J, Emberton M. Men’s experiences of having lower urinary tract symptoms: Factors relating to bother. BJU Int. 2004;94:563- 7.
Marschall-Kehrel D. Update on nocturia: the best of rest is sleep .Urology. 2004;64: 21–4.
Ruscio A, Stein D, Chiu W, Kessler R. The epidemiology of obsessive-compulsive disorder in the national comorbidity survey replication. Mol Psychiatry. 2010;15(1):53–63.
Asplund R, Henriksson S, Johansson S , Isacsson G. Nocturia and depression .BJU Int. 2004;93:1253–6.