|
1
|
Li T, Di X, Li Y, Wei J, Liao B, Wang K. The Association between Depression and Overactive Bladder: A Cross-Sectional Study of NHANES 2011-2018. Int Urogynecol J 2025; 36:373-380. [PMID: 39570370 DOI: 10.1007/s00192-024-05991-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 10/28/2024] [Indexed: 11/22/2024]
Abstract
INTRODUCTION AND HYPOTHESIS The relationship between depression and overactive bladder (OAB) is unknown. This study aimed to explore the association between depression and OAB in the U.S. POPULATION METHODS A cross-sectional study was performed utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. Depression status and severity among participants were assessed via the Patient Health Questionnaire-9 (PHQ-9). The OAB symptoms of the participants were assessed via the OAB symptom score (OABSS) scale. Multivariate logistic regression was conducted to evaluate the association between depression and OAB. RESULTS A total of 19,359 participants were enrolled in the study, with 91.01% (N = 17618) exhibiting minimal or mild depression, 7.92% (N = 1533) presenting with moderate or moderately severe depression, and 1.07% (N = 208) identified as severe depression. The overall prevalence of OAB was 21.62%. We found that depression was positively associated with OAB before and after adjustments for all covariates. After adjusting for covariates, individuals with moderate or moderately severe depression presented an elevated risk of OAB (OR = 2.52, 95% CI 2.11-3.01, p < 0.01), while those with severe depression presented a greater risk (OR = 3.74 95% CI 2.37-5.90, p < 0.01) than did participants with minimal or mild depression. Age may modify the correlation between depression and OAB. CONCLUSIONS Our study highlighted a positive association between depression and OAB in the U.S. population, and the association between depression and OAB was modified by age. However, more studies are needed in the future to verify the associations between depression and OAB and their underlying mechanisms.
Collapse
Affiliation(s)
- Tianyue Li
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China
| | - Xingpeng Di
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China
| | - Ya Li
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China
| | - Jingwen Wei
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China
| | - Banghua Liao
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China
| | - Kunjie Wang
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China.
| |
Collapse
|
|
2
|
Rogowski A, Krowicka-Wasyl M, Dybowski B, Sienkiewicz-Jarosz H, Wichniak A, Samochowiec J, Wojnar M, Issat T, Syrylo T, Jankiewicz K, Bieńkowski P. Benzodiazepines use and dependence in female patients with overactive bladder symptoms - prevalence and clinical correlations. Cent European J Urol 2024; 77:641-648. [PMID: 40313703 PMCID: PMC12042402 DOI: 10.5173/ceju.2024.0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Accepted: 11/08/2024] [Indexed: 05/03/2025] Open
Abstract
Introduction GABAergic sedative-hypnotics, including benzodiazepines (BDZs) and Z-drugs, are some of the most used and misused psychotropic medications in developed countries. Growing evidence points to the role of psychiatric comorbidities in overactive bladder (OAB) and in urge urinary incontinence. The aim of the present study was to evaluate: 1) the prevalence of BDZs and/or Z-drugs use in female OAB patients, 2) the risk of dependence on BDZs and/or Z-drugs in female OAB patients, 3) the relationship between the use of BDZs and/or Z-drugs and the severity of OAB symptoms. Material and methods The prevalence of BDZs and/or Z-drugs use, the risk of dependence on BDZs and/or Z-drugs, and the relationship between the use of BDZs and/or Z-drugs and the severity of OAB symptoms was assessed in OAB patients recruited in the urogynecological outpatient clinic. Results A higher percentage of OAB patients confirmed the use of GABAergic sedative-hypnotics in the last 12 months as compared to the non-OAB outpatients presenting for routine gynecological prophylaxis. A larger number of OAB patients (5.6%) met the diagnosis of lifetime BDZ (and/or Z-drug) dependence as compared to the controls (0.9%). The use of sedative-hypnotics did not correlate with OAB symptoms. Conclusions Our results suggest that the use of and dependence on GABAergic sedative-hypnotics may be associated with the OAB diagnosis in female urogynecological patients.
Collapse
Affiliation(s)
- Artur Rogowski
- Department of Minimally Invasive and Endoscopic Gynecology, Military Institute of Medicine, Legionowo, Poland
| | - Maria Krowicka-Wasyl
- Department of Obstetrics and Gynecology, Mother and Child Institute, Warsaw, Poland
| | | | | | - Adam Wichniak
- Sleep Medicine Center and Third Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Poland
| | - Tadeusz Issat
- Department of Obstetrics and Gynecology, Mother and Child Institute, Warsaw, Poland
| | - Tomasz Syrylo
- Department of General, Oncological and Functional Urology, Military Institute of Medicine, Warsaw, Poland
| | | | | |
Collapse
|
|
3
|
Zhang Y, Wu X, Liu G, Feng X, Jiang H, Zhang X. Association between overactive bladder and depression in American adults: A cross-sectional study from NHANES 2005-2018. J Affect Disord 2024; 356:545-553. [PMID: 38642902 DOI: 10.1016/j.jad.2024.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/12/2024] [Accepted: 04/08/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND AND AIM Overactive bladder (OAB) and depression are both common disorders and there is research suggesting an association between the two, but there is a lack of studies with large samples. The aim of this study is to investigate the association between OAB and depressive symptoms. METHODS We used data from the National Health and Nutrition Examination Survey (NHANES) database for the period 2005 to 2018. OAB was characterized by the Overactive Bladder Symptom Score (OABSS, score > 3) and depression was diagnosed by the Patient Health Questionnaire (PHQ-9, score ≥ 10). There were three models employed in our analysis: (1) Crude model was unadjusted; (2) Model 1 was adjusted for age, sex, race/ethnicity, educational level, and marital status; (3) Model 2 was adjusted for factors in Model 1 plus the remained potential covariates. We used survey-weighted logistic regression models to assess the association between OAB and depression. Subsequently, subgroup analyses and smoothed curve analyses were used to evaluate the reliability of the findings. RESULTS Finally, a total of 6612 participants were included in our study, consisting of 1005 participants with diagnosis of OAB and 5607 participants without diagnosis of OAB. After adjusting for all covariates, there was a significant positive association between OAB and depression (OR: 2.89, 95 % CI: 1.91, 4.37). The severity of OAB was also positively associated with depression. Compared to participants without OAB, the fully adjusted ORs for depression were 2.76 (95 % CI: 1.64, 4.65) for those with mild OAB, 3.79 (95 % CI: 1.68, 8.55) for those with moderate OAB, and 5.21 (95 % CI: 1.39, 19.53) for those with severe OAB. CONCLUSIONS This study revealed a strong association between OAB and depression and a progressive increase in the risk of depression as the severity of OAB (mild, moderate, and severe) increased. Therefore, it is important for clinicians to recognize the assessment of OAB symptoms in patients who are at risk for or have developed depressive symptoms, as well as the mental health of patients with OAB.
Collapse
Affiliation(s)
- Yuyang Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University, Anhui Province, China
| | - Xu Wu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University, Anhui Province, China
| | - Guodong Liu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University, Anhui Province, China
| | - Xingliang Feng
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
| | - Hui Jiang
- Department of Urology, Peking University First Hospital Institute of Urology, Peking University Andrology Center, Beijing, China.
| | - Xiansheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University, Anhui Province, China.
| |
Collapse
|
|
4
|
Di Bello F, Scandurra C, Muzii B, Colla’ Ruvolo C, Califano G, Mocini E, Creta M, Napolitano L, Morra S, Fraia A, Bochicchio V, Salzano G, Vaira LA, Mangiapia F, Motta G, Motta G, Maldonato NM, Longo N, Cantone E. Are Excessive Daytime Sleepiness and Lower Urinary Tract Symptoms the Triggering Link for Mental Imbalance? An Exploratory Post Hoc Analysis. J Clin Med 2023; 12:6965. [PMID: 38002580 PMCID: PMC10672561 DOI: 10.3390/jcm12226965] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/04/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Both lower urinary tract symptoms (LUTS) and excessive daytime sleepiness (EDS) could negatively impair the patients' quality of life, increasing the sensitivity to psychological distress that results in mental health disorders. The relationships of both urinary and respiratory domains with psychological distress in obstructive sleep apnea patients is still underestimated. METHODS This study was a post hoc analysis of a web-based Italian survey, which included 1998 participants. Three hierarchical multiple linear regression analyses with psychological distress as dependent variable were performed on the study of 1988 participants enrolled in the final analysis. Cohen's f2 was used for the assessment of the effect size. RESULTS From the hierarchical multiple linear regression analyses, it emerged that the final statistical model (including sociodemographic characteristics, comorbidities, perceived urinary function, and excessive daytime sleepiness) for all dimensions accounted for 16.7% of the variance in psychological distress, with a medium effect size (f2 = 0.15). CONCLUSIONS People reported psychological distress was impaired by the presence of LUTS and EDS. Specifically, our study showed that higher levels of distress were scored especially in young women exhibiting urinary symptoms and with high values of daytime sleepiness.
Collapse
Affiliation(s)
- Francesco Di Bello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Cristiano Scandurra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Benedetta Muzii
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Claudia Colla’ Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University, 00185 Rome, Italy;
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Agostino Fraia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Vincenzo Bochicchio
- Department of Humanistic Studies, University of Calabria, 87036 Rende, Italy;
| | - Giovanni Salzano
- Maxillofacial Surgery Operative Unit, University Hospital of Naples “Federico II”, 80131 Naples, Italy;
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy;
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Gaetano Motta
- ENT Unit, Department of Mental, Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.M.)
| | - Giovanni Motta
- ENT Unit, Department of Mental, Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.M.)
| | - Nelson Mauro Maldonato
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Elena Cantone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| |
Collapse
|