From the Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN.
School of Nursing, University of Alabama at Birmingham, Birmingham, AL.
Menopause. 2023 Jul 1;30(7):723-731. doi: 10.1097/GME.0000000000002193. Epub 2023 May 10.
The aim of the study is to examine the association between depressive symptoms and subsequent lower urinary tract symptoms (LUTS) and impact (a composite outcome) among women (N = 1,119) from the Coronary Artery Risk Development in Young Adults study.
The Center for Epidemiologic Studies-Depression Scale (CES-D) was administered in 1990-1991 and every 5 years through 2010-2011. In 2012-2013, LUTS and impact data were collected for the first time. Accumulation of risk was examined in the following three ways: (1) mean CES-D score across 20 years (5 observations); (2) depressive symptom trajectory group, determined by group-based trajectory modeling; and (3) intercepts and slopes obtained from women's individual CES-D score trajectories through two-stage mixed effects modeling. For each approach, ordinal logistic regression analyses examined odds of having "greater LUTS/impact" for each unit change in a depressive symptom variable.
(1) With each one-unit increase in mean CES-D score over the 20-year period, women were 9% more likely to report greater LUTS/impact (odds ratio [OR] = 1.09, 95% CI = 1.07-1.11). (2) In comparison with women with consistently low depressive symptoms, women with consistently threshold depression or consistently high depressive symptoms were twice (OR = 2.07, 95% CI = 1.59-2.69) and over five times (OR = 5.55, 95% CI = 3.07-10.06) as likely, respectively, to report greater LUTS/impact. (3) Women's individual symptom intercept and slope interacted. Increases in depressive symptoms across 20 years (greater slopes) were associated with greater LUTS/impact when women's initial CES-D score (intercept) was in the moderate-to-high range relative to the sample.
Depressive symptoms over 20 years, examined with different degrees of nuance, were consistently associated with subsequently measured LUTS and impact.
本研究旨在探讨抑郁症状与随后的下尿路症状（LUTS）及影响（综合结局）之间的关系，研究对象为来自冠状动脉风险发展青年研究的女性（N=1119）。
1990-1991 年和 2010-2011 年期间每 5 年进行一次中心流行病学研究抑郁量表（CES-D）测试。2012-2013 年首次收集 LUTS 和影响数据。通过以下三种方式检查风险的积累：（1）20 年的平均 CES-D 评分（5 个观察值）；（2）基于群组轨迹建模确定的抑郁症状轨迹组；（3）通过两阶段混合效应建模从女性个体 CES-D 评分轨迹中获得的截距和斜率。对于每种方法，有序逻辑回归分析检查了抑郁症状变量每单位变化与“更严重的 LUTS/影响”的比值比（OR）。
（1）在 20 年的时间里，平均 CES-D 评分每增加一个单位，女性报告更严重的 LUTS/影响的可能性增加 9%（OR=1.09，95%CI=1.07-1.11）。（2）与抑郁症状持续较低的女性相比，持续处于阈下抑郁或持续处于高抑郁症状的女性报告更严重的 LUTS/影响的可能性分别增加两倍（OR=2.07，95%CI=1.59-2.69）和五倍以上（OR=5.55，95%CI=3.07-10.06）。（3）女性个体症状截距和斜率相互作用。在考虑样本的情况下，当女性初始 CES-D 评分（截距）处于中高范围时，20 年内抑郁症状的增加（较大的斜率）与更严重的 LUTS/影响相关。
20 年内的抑郁症状，通过不同程度的细微差别进行检查，与随后测量的 LUTS 和影响始终相关。
