Faculty of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina.
Psychiatr Danub. 2021 Winter;33(4):485-490. doi: 10.24869/psyd.2021.485.
Although available diagnostic criteria are intelligible, combination of OAB and anxiety in the same patient presents a perfect example of medical causality dilemma, commonly stated as the question: "which came first: the chicken or the egg?". The aim of this review article is to address available insights in bidirectional association between OAB and anxiety.
In this review article, we included different types of studies whose results are presented as relative risk (RR) or odds ratio (OR) with a 95% accuracy. A literature search was conducted with the use of the PubMed and EMBASE electronic databases focusing on identifying articles published in English between 1990 and 2020.
The electronic searches, after duplicate records removal, provided a total of 126 citations. Of these, 107 were excluded after title/abstract screening (not relevant to the review). We examined the full text of 19 publications remaining to summarize possible mechanisms between OAB and anxiety. According to examined literature, our result synthesis provides insight in epidemiology, pathophysiology, diagnostic and therapeutic approach of both conditions.
Temporal relationship between OAB and anxiety is not very well documented because available longitudinal cohort studies are limited. The limitation of the published literature is that most were population-based symptom studies demonstrating high risk of bias. Although data from analysed studies suggest that anxiety and OAB and anxiety might be casually related, studies provided on clinical population are warranted. In addition to the traditional urologic factors, we recommend that psychosocial factors such as anxiety should be assessed routinely in patients with OAB.
尽管现有的诊断标准易于理解，但在同一患者中同时存在 OAB 和焦虑，这是一个医学因果关系困境的完美示例，通常表述为：“是先有鸡还是先有蛋？”。本文旨在探讨 OAB 和焦虑之间的双向关联。
在本文中，我们纳入了不同类型的研究，其结果以相对风险（RR）或比值比（OR）表示，具有 95%的准确性。使用 PubMed 和 EMBASE 电子数据库进行文献检索，重点是识别 1990 年至 2020 年间以英文发表的文章。
经过重复记录去除后，电子搜索共提供了 126 条引文。其中，107 条在标题/摘要筛选后被排除（与综述不相关）。我们检查了其余 19 篇文献的全文，以总结 OAB 和焦虑之间可能存在的机制。根据所检查的文献，我们的结果综合提供了这两种情况的流行病学、病理生理学、诊断和治疗方法的见解。
OAB 和焦虑之间的时间关系没有很好地记录下来，因为现有的纵向队列研究有限。已发表文献的局限性在于，大多数都是基于人群的症状研究，存在很高的偏倚风险。尽管分析研究的数据表明焦虑和 OAB 可能存在因果关系，但需要对临床人群进行研究。除了传统的泌尿科因素外，我们建议常规评估 OAB 患者的心理社会因素，如焦虑。
