Häkkinen Jukka T, Shiri Rahman, Koskimäki Juha, Tammela Teuvo L J, Auvinen Anssi, Hakama Matti
Department of Urology, Tampere University Hospital, Tampere, Finland.
J Urol. 2008 May;179(5):1897-901. doi: 10.1016/j.juro.2008.01.037. Epub 2008 Mar 18.
We assessed the effects of depressive symptoms on the incidence of nocturia in men.
The target population comprised all men who were 50, 60 or 70 years old and residing in the Tampere area in 1994. A self-administered questionnaire was mailed to 3,143 randomly selected men in 1994 and a second round was mailed to the 2,837 who were alive and eligible in 1999. The followup sample consisted of 1,580 men with information on nocturia available at baseline and followup.
The incidence of mild to severe nocturia was 75 cases per 1,000 person-years (95% CI 66-85) and that of moderate or severe nocturia was 9 (95% CI 7-11). Men with depressive symptoms at study entry were at 2.8 times higher risk (95% CI 1.5-5.2) for moderate or severe nocturia than those without depressive symptoms. A dose response relation was found between the severity of depressive symptoms at baseline and the incidence of moderate or severe nocturia. Each unit increment in the short form of the Mental Health Inventory score on a scale of 5 to 30 increased the incidence rate ratio of moderate or severe nocturia by 10% (95% CI 4-16). Only untreated depressive symptoms increased the incidence of moderate or severe nocturia (adjusted RR 3.3, 95% CI 1.7-6.2) but not medically treated symptoms. Nocturia at study entry had no significant effect on depressive symptoms during followup.
Our findings show a unidirectional effect of depressive symptoms on the incidence of moderate or severe nocturia. Untreated depressive symptoms may cause nocturia.
我们评估了抑郁症状对男性夜尿症发病率的影响。
目标人群包括1994年居住在坦佩雷地区的所有50岁、60岁或70岁男性。1994年,一份自填式问卷被邮寄给3143名随机挑选的男性,1999年,第二轮问卷被邮寄给2837名存活且符合条件的男性。随访样本包括1580名在基线和随访时均有夜尿症相关信息的男性。
轻度至重度夜尿症的发病率为每1000人年75例(95%可信区间66 - 85),中度或重度夜尿症的发病率为9例(95%可信区间7 - 11)。研究开始时存在抑郁症状的男性发生中度或重度夜尿症的风险比没有抑郁症状的男性高2.8倍(95%可信区间1.5 - 5.2)。在基线时抑郁症状的严重程度与中度或重度夜尿症的发病率之间发现了剂量反应关系。心理健康量表简表得分在5至30分范围内每增加一个单位,中度或重度夜尿症的发病率比值增加10%(95%可信区间4 - 16)。只有未治疗的抑郁症状会增加中度或重度夜尿症的发病率(调整后的风险比3.3,95%可信区间1.7 - 6.2),而接受药物治疗的症状则不会。研究开始时的夜尿症对随访期间的抑郁症状没有显著影响。
我们的研究结果表明抑郁症状对中度或重度夜尿症的发病率有单向影响。未治疗的抑郁症状可能导致夜尿症。