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. 2023 Jul 1;30(7):723-731.
doi: 10.1097/GME.0000000000002193. Epub 2023 May 10.

Trajectories of depressive symptoms over 20 years and subsequent lower urinary tract symptoms and impact among women

Sonya S Brady  1 , Liang Shan  2 , Alayne D Markland  3 , Jared D Huling  4 , Andrés Arguedas  4 , Cynthia S Fok  5 , Stephen K Van Den Eeden, Cora E Lewis  6
Affiliations

Trajectories of depressive symptoms over 20 years and subsequent lower urinary tract symptoms and impact among women

Sonya S Brady et al. Menopause. .

Abstract

Objective: The aim of the study is to examine the association between depressive symptoms and subsequent lower urinary tract symptoms (LUTS) and impact (a composite outcome) among women (N = 1,119) from the Coronary Artery Risk Development in Young Adults study.

Methods: The Center for Epidemiologic Studies-Depression Scale (CES-D) was administered in 1990-1991 and every 5 years through 2010-2011. In 2012-2013, LUTS and impact data were collected for the first time. Accumulation of risk was examined in the following three ways: (1) mean CES-D score across 20 years (5 observations); (2) depressive symptom trajectory group, determined by group-based trajectory modeling; and (3) intercepts and slopes obtained from women's individual CES-D score trajectories through two-stage mixed effects modeling. For each approach, ordinal logistic regression analyses examined odds of having "greater LUTS/impact" for each unit change in a depressive symptom variable.

Results: (1) With each one-unit increase in mean CES-D score over the 20-year period, women were 9% more likely to report greater LUTS/impact (odds ratio [OR] = 1.09, 95% CI = 1.07-1.11). (2) In comparison with women with consistently low depressive symptoms, women with consistently threshold depression or consistently high depressive symptoms were twice (OR = 2.07, 95% CI = 1.59-2.69) and over five times (OR = 5.55, 95% CI = 3.07-10.06) as likely, respectively, to report greater LUTS/impact. (3) Women's individual symptom intercept and slope interacted. Increases in depressive symptoms across 20 years (greater slopes) were associated with greater LUTS/impact when women's initial CES-D score (intercept) was in the moderate-to-high range relative to the sample.

Conclusions: Depressive symptoms over 20 years, examined with different degrees of nuance, were consistently associated with subsequently measured LUTS and impact.

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Conflict of interest statement

Financial disclosures/conflicts of interest: A.D.M. receives institutional funding from the Agency for Healthcare Research and Quality. C.S.F. receives ongoing funding from UpToDate and past funding from UroCure. S.K.V.D.E. receives funding from Michael J Fox Foundation and Freenome. The other authors have nothing to disclose.

Figures

Figure 1.
Figure 1.
Estimated Probability of Having Moderate or Severe LUTS and Impact versus Bladder Health or Mild LUTS and Impact, by Initial Depressive Symptoms (Intercept) and Change in Depressive Symptoms Over Time (Slope) “CES-D = Center for Epidemiologic Studies-Depression Scale; LUTS = lower urinary tract symptoms; M = mean; SD = standard deviation.”
See this image and copyright information in PMC

References

    1. Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. Jan 2010;21(1):5–26. doi:10.1007/s00192-009-0976-9 - DOI - PubMed
    1. Reynolds WS, Fowke J, Dmochowski R. The Burden of Overactive Bladder on US Public Health. Curr Bladder Dysfunct Rep. Mar 2016;11(1):8–13. doi:10.1007/s11884-016-0344-9 - DOI - PMC - PubMed
    1. Minassian VA, Bazi T, Stewart WF. Clinical epidemiological insights into urinary incontinence. Int Urogynecol J. May 2017;28(5):687–696. doi:10.1007/s00192-017-3314-7 - DOI - PubMed
    1. Bogner HR, O’Donnell AJ, de Vries HF, Northington GM, Joo JH. The temporal relationship between anxiety disorders and urinary incontinence among community-dwelling adults. J Anxiety Disord. Mar 2011;25(2):203–8. doi:10.1016/j.janxdis.2010.09.003 - DOI - PMC - PubMed
    1. Coyne KS, Wein A, Nicholson S, Kvasz M, Chen CI, Milsom I. Comorbidities and personal burden of urgency urinary incontinence: a systematic review. Int J Clin Pract. Oct 2013;67(10):1015–33. doi:10.1111/ijcp.12164 - DOI - PubMed

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