Steers W D, Lee K S
Department of Urology, University of Virginia School of Medicine, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
World J Urol. 2001 Nov;19(5):351-7. doi: 10.1007/s003450100227.
The urologic literature suggests that there is an association between a variety of psychiatric disorders and incontinence. Most notably, depression is found in a significant percentage of patients with urinary incontinence. Depression also occurs in other conditions associated with urinary urge incontinence, such as aging and dementia, and in neurologic disorders such as normal pressure hydrocephalus. Correction of some neurologic disorders eliminates both depression and urge incontinence. Although chronic medical disorders such as urge incontinence may lead to depression, an alternative hypothesis is that these two conditions share a common neurochemical pathogenesis. Lowering monoamines such as serotonin and noradrenaline in the central nervous system (CNS) leads to depression and urinary frequency and a hyperactive bladder in experimental animals. Thus, depression may not only be the result of persistent urinary incontinence, but individuals with altered CNS monoamines could manifest both depression and an overactive bladder. The latter condition may lead to urge incontinence, urinary frequency, urgency, or enuresis. Uncovering further evidence for such a linkage could serve as the basis for the development of genetic markers and novel therapeutic interventions for these two conditions.
泌尿学文献表明，多种精神疾病与尿失禁之间存在关联。最值得注意的是，相当比例的尿失禁患者存在抑郁症。抑郁症也出现在与急迫性尿失禁相关的其他情况中，如衰老和痴呆，以及诸如正常压力脑积水等神经系统疾病中。纠正某些神经系统疾病可消除抑郁症和急迫性尿失禁。虽然诸如急迫性尿失禁等慢性疾病可能导致抑郁症，但另一种假说是，这两种情况具有共同的神经化学发病机制。在实验动物中，降低中枢神经系统（CNS）中的血清素和去甲肾上腺素等单胺会导致抑郁症、尿频和膀胱过度活动。因此，抑郁症可能不仅是持续性尿失禁的结果，而且中枢神经系统单胺改变的个体可能同时表现出抑郁症和膀胱过度活动。后一种情况可能导致急迫性尿失禁、尿频、尿急或遗尿。为这种联系找到更多证据可为这两种疾病的遗传标记物开发和新型治疗干预措施提供依据。
