A prospective study examining the association between the symptoms of anxiety and depression and severity of urinary incontinence.

OBJECTIVE

To investigate the association of the presence or absence of the symptoms of anxiety and depression compared with the 48 h pad test as an objective measure of incontinence.

DESIGN

Prospective study.

SETTING

Urodynamics clinic in a large teaching hospital.

SUBJECTS

All patients with urinary incontinence attending for urodynamic assessment from 23.4.96 to 29.10.96.

INTERVENTIONS

48 h pad test, Hospital Anxiety and Depression scale (HAD scale).

MAIN OUTCOME MEASURES

Urodynamic diagnosis of cause of incontinence. Urinary loss over 48 h as measured by weight change in pads. Presence of symptoms of anxiety or depression as defined by HAD scale score of 8 or more.

RESULTS

Urodynamic investigation was performed for incontinence on 133 patients. Of these 127 (95.4%) completed the HAD scale questionnaire. Of the 43 patients (32.2%) who returned the pads 18 (41.8%) patients were found to have symptoms of anxiety and six patients (13.9%) had symptoms of depression. Patients with symptoms of anxiety had lower mean measured urinary loss over a 48 h period compared to women with no symptoms of anxiety (median loss 44.2 ml range 6.8-622.4 versus 97.1 ml range 8.2-4384.4 ml) (P=0.05). There was no significant association between symptoms of depression and pad test results.

CONCLUSIONS

Patients presenting with incontinence who have symptoms of anxiety are on average less incontinent compared to than those without symptoms of anxiety. It suggests that anxious patients present with a lesser degree of incontinence than nonanxious patients.