Bladder trouble tied to depression, anxiety

NEW YORK (Reuters Health) - Women who suffer from "dysfunctional voiding" -- like having to urinate often and having difficulty voiding -- experience a greater degree of depression and anxiety compared to women without these symptoms, research suggests.

"Dysfunctional voiding ... is more commonly seen in recent years," Dr. Alex T. L. Lin, of Taipei Veterans General Hospital, Taiwan, told Reuters Health. "Although we suspect that depression and anxiety are reactions to the dysfunctional voiding, we could not preclude the possibility that psychological abnormalities might predispose one to the occurrence of lower urinary tract dysfunction," he commented.

Lin noted that the stressful environment of modern society might be a contributing factor for the increased incidence of dysfunctional voiding.

"From our observations, avoiding stressful situations and stress-reduction are important to prevent dysfunctional voiding," Lin advised.

Lin and colleagues assessed anxiety and depression symptoms among 32 women with dysfunctional voiding and 31 asymptomatic control women with no lower urinary tract symptoms. The average age of the women studied was 48 years.

The women with dysfunctional voiding scored markedly higher on the Hamilton Rating Scale for Depression (HRSD) and the Hamilton Rating Scale for Anxiety (HAM-A).

The patients had an average HRSD score of 16.9, compared with 4.3 in controls. The mean HAM-A score for patients was 21.2 and 4.8 for controls.

A significantly greater degree of depression and anxiety was observed among patients with dysfunctional voiding compared to controls.

"For patients with dysfunctional voiding, psychological intervention to reduce anxiety and depression should be an indispensable part of the treatment plan," Lin said.

The researchers' next step is to assess the treatment benefit of psychological interventions on dysfunctional voiding.

SOURCE: Urology April, 2008.