From the Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, MA.
Department of Obstetrics and Gynecology, State University of Campinas, Campinas, SP.
Female Pelvic Med Reconstr Surg. 2021 Feb 1;27(2):e442-e447. doi: 10.1097/SPV.0000000000000958.
This study aimed to investigate whether the occurrence of urinary incontinence (UI) is associated with increased odds of depression in perimenopausal and postmenopausal women.
This cross-sectional study included 208 women with depressive symptoms, confirmed by the Beck Depression Inventory, and 247 patients without depression. All participants were perimenopausal or postmenopausal women aged 35 to 65 years who attended an outpatient clinic from a tertiary-academic hospital in Northeastern Brazil. Urinary incontinence symptoms were assessed using patient's self-report and the validated versions of the International Consultation on Incontinence Questionnaire-Short Form and the Questionnaire for Urinary Incontinence Diagnosis. To investigate the severity of climacteric symptoms, the Blatt-Kupperman Index was used, and menopause-related quality of life was analyzed using the Utian Quality of Life Questionnaire.
In univariate analysis, the Beck Depression Inventory-II mean scores for UI and non-UI women were, respectively, 15.5 (95% confidence interval, 14.28-16.72) and 11.83 (10.52-13.13; P < 0.05). Patients with moderate and severe scores of depression reported higher International Consultation on Incontinence Questionnaire-Short Form and Questionnaire for Urinary Incontinence Diagnosis scores when compared with women with mild depression scores and women without depression (P < 0.001). Conversely, in multivariate analysis, having UI was not associated with having depression (odds ratio [OR], 0.85; 0.52-1.37; P = 0.50), after adjusting for confounders. Older age (>55 years) was associated with decreased odds of depression (OR, 0.43; 0.21-0.88; P = 0.02), whereas moderate (OR, 2.28; 1.40-3.71; P = 0.001) and severe (OR, 7.70; 2.79-21.23) intensities of menopause symptoms were associated with increased odds of depression.
Urinary incontinence was not associated with depression within climacteric women after multivariate analysis.
本研究旨在探讨绝经前后女性尿失禁（UI）的发生是否与抑郁的发生几率增加有关。
这是一项横断面研究，共纳入 208 例贝克抑郁自评量表（BDI）确诊为抑郁的患者和 247 例非抑郁患者。所有参与者均为年龄在 35 至 65 岁之间、来自巴西东北部一所三级教学医院的门诊围绝经期或绝经后女性。尿失禁症状通过患者的自我报告和经过验证的国际尿失禁咨询问卷-短表（ICIQ-SF）和尿失禁诊断问卷的版本进行评估。为了调查绝经期症状的严重程度，使用了 Blatt-Kupperman 指数，并用 Utian 生活质量问卷分析了与绝经相关的生活质量。
在单因素分析中，UI 组和非 UI 组的贝克抑郁自评量表 II 平均得分分别为 15.5（95%置信区间，14.28-16.72）和 11.83（10.52-13.13；P<0.05）。与轻度抑郁评分的女性和无抑郁的女性相比，中重度抑郁评分的患者报告了更高的 ICIQ-SF 和尿失禁诊断问卷评分（P<0.001）。相反，在多因素分析中，调整混杂因素后，患有 UI 与患有抑郁无关（比值比 [OR]，0.85；0.52-1.37；P=0.50）。年龄较大（>55 岁）与抑郁几率降低相关（OR，0.43；0.21-0.88；P=0.02），而中度（OR，2.28；1.40-3.71；P=0.001）和重度（OR，7.70；2.79-21.23）的绝经期症状强度与抑郁几率增加相关。
在调整多变量后，尿失禁与围绝经期女性的抑郁无关。
