PURPOSE: To examine the association between depression, suicidal ideation and self-reported lower urinary tract symptoms (LUTS) from a large cross-sectional population-based study.
MATERIALS AND METHODS: The study included 2,890 men from the 2005-2006 or 2007-2008 cycles of the National Health and Nutrition Examination Survey, who were ≥ 40 years old. Men were asked if they experienced nocturia, urinary hesitancy and/or incomplete bladder emptying. The Patient Health Questionnaire-9 (PHQ-9) was utilized to determine the likelihood of clinical depression and suicidal ideation.
RESULTS: The prevalence of LUTS was 33.7% and 10.3% for men reporting 1 symptom and ≥ 2 symptoms, respectively. Moderate to severe depression (PHQ-9 score ≥10) and suicidal ideation were reported by 181 (6.3%) and 105 (3.6%) men, respectively. Men reporting moderate to severe depression (compared with men reporting minimal depression) had a higher odds of reporting LUTS: Adjusted Odds Ratio (AOR), 5.09 (95% CI, 3.17-8.17]) for PHQ-9 scores 5-9 and AOR, 7.62 (95%CI, 3.90-14.87) for PHQ-9 scores ≥10; p-trend=< 0.0001. Greater LUTS symptoms was associated with a significantly higher odds of moderate to severe depression (AOR, 3.09 (95% CI, 1.86-5.15) for 1 symptom and AOR, 8.06 (95% CI, 4.18-15.53) for ≥2 symptoms; p-trend=< 0.0001) and a higher odds of suicidal ideation (AOR, 1.70 (95%, 0.85-3.42) and OR, 2.71 (95% CI, 1.40, 5.25), respectively; p-trend=0.004).
CONCLUSIONS: A significant relationship was observed between LUTS and depression/suicidal ideation. While the pathophysiology of the relationship and its significance to clinical practice remain unclear, clinicians may consider screening men with severe LUTS for depression.
Written by:
Breyer BN, Kenfield SA, Blaschko SD, Erickson BA. Are you the author?
University of California-San Francisco, Department of Urology; University of Iowa, Department of Urology.
Reference: J Urol. 2013 Dec 13. pii: S0022-5347(13)06106-5.
doi: 10.1016/j.juro.2013.12.012
PubMed Abstract
PMID: 24342145
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