Heymen Steve
Department of Medicine, Division of Digestive Diseases, University of North Caroline at Chapel Hill, 27599-7080, USA.
Gastroenterology. 2004 Jan;126(1 Suppl 1):S146-51. doi: 10.1053/j.gastro.2003.10.040.
An estimated 15% to 30% of adults over the age of 60 years have urinary incontinence, which is often reported as severe. Although psychological symptoms, especially anxiety and depression, are often associated with urinary incontinence, it seems likely that psychological distress is not a cause but a consequence of suffering from the condition. Cognitive deficits that directly interfere with the neurologic function of the bladder and/or diminish the ability to communicate appear to be important contributors to urinary incontinence. The incidence of fecal incontinence is high in children up to the age of 9 years and ranges from 7% to nearly 10% in adults over the age of 65 years. Although it has been suggested that psychological symptoms can cause fecal incontinence, data are lacking to support a causative association. Psychological disorders and incontinence of urine and feces appear to be common comorbidities. Studies are needed to determine whether the incidence of psychological symptoms in persons with incontinence is comparable for those who seek treatment and those who do not and to compare psychometric and quality-of-life measures before and after treatment to help determine the role of psychological symptoms in persons with fecal and urinary incontinence.
据估计，60岁以上的成年人中有15%至30%患有尿失禁，而且通常报告为严重尿失禁。尽管心理症状，尤其是焦虑和抑郁，常常与尿失禁相关，但心理困扰似乎并非该病的病因，而是患病的结果。直接干扰膀胱神经功能和/或降低沟通能力的认知缺陷似乎是导致尿失禁的重要因素。9岁以下儿童大便失禁的发生率较高，65岁以上成年人的发生率在7%至近10%之间。尽管有人提出心理症状可导致大便失禁，但缺乏支持因果关系的数据。心理障碍与大小便失禁似乎是常见的共病。需要开展研究，以确定寻求治疗者与未寻求治疗者中尿失禁患者心理症状的发生率是否相当，并比较治疗前后的心理测量指标和生活质量指标，以帮助确定心理症状在大便失禁和尿失禁患者中的作用。
