Evaluation of depression and anxiety in women with urinary incontinence
Article published in Urologia Polska 2008/61/Supl. 1.

authors

Joanna Broda-Orlińska, Piotr Radziszewski, Andrzej Borkowski

Klinika Urologii AM w Warszawie

summary

Introduction.

Urinary incontinence is an important and common health care problem af-fecting the elderly population. Without treatment, urinary incontinence (UI) may lead to seri-ous psychological and social complications such as depression, anxiety, embarrasment, low self- esteem and social isolation

Objective.

The study investigated the association between anxiety and depression and uri-nary incontinence (urge, stress and mixed) and the direction of casual pathways between these variables.

Material and methods.

Questionnaires were mailed to 100 women aged 42-79 years (mean 63 years) with UI, who had taken urodynamics. The questionnaires included UDI-6 ( urinary distress inventory) questionnaire which evaluated urinary symptoms and Hospital Anxiety and Depresion Scale(HADS). The HADS scale allows to asses severity and caseness of anxi-ety disorders and depression in both somatic, and psychiatric cases and in primary care pa-tients and the general population. The HADS contains 16 items and consists of two sub-scales: anxiety and depression. Each item is rated on a four-point scale, giving maximum scores of 21 for anxiety and depression. Scores of 11 or more on either subscale are consid-ered to be a significant (case) of psychological morbidity, while scores of 8-10 represents (borderline)

and 0-7 (normal).

Results.

Among 45 women who responded to the survey (response rate 45%) 21 patients showed stress urinary incontinence(SUI), 11 urge urinary incontinence (UUI) and 14 mixed urinary incontinence(MUI). A significant proportion of women with urge and mixed inconti-nence reported symptoms of anxiety (63.6% UUI, 57.1% MUI) and depression (54.5% UUI, 50 % MUI) in comparison with women with SUI (anxiety 28.6%, depresion 33.3%). Overall, depression was reported by 20 women (44.4%) and anxiety was reported by 21 women (46.7%). Anxiety and depression were associated with a number of urinary symptoms.

Conclusions.

This study provides objective evidence that patients with UUI and MUI have a higher degree of anxiety than those with pure SUI. Both anxiety and depression could coused delayed reconvalescence of this patients and interfear with their therapeutic proces itself.