Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University, Anhui Province, China.
Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
J Affect Disord. 2024 Jul 1;356:545-553. doi: 10.1016/j.jad.2024.04.030. Epub 2024 Apr 18.
Overactive bladder (OAB) and depression are both common disorders and there is research suggesting an association between the two, but there is a lack of studies with large samples. The aim of this study is to investigate the association between OAB and depressive symptoms.
We used data from the National Health and Nutrition Examination Survey (NHANES) database for the period 2005 to 2018. OAB was characterized by the Overactive Bladder Symptom Score (OABSS, score > 3) and depression was diagnosed by the Patient Health Questionnaire (PHQ-9, score ≥ 10). There were three models employed in our analysis: (1) Crude model was unadjusted; (2) Model 1 was adjusted for age, sex, race/ethnicity, educational level, and marital status; (3) Model 2 was adjusted for factors in Model 1 plus the remained potential covariates. We used survey-weighted logistic regression models to assess the association between OAB and depression. Subsequently, subgroup analyses and smoothed curve analyses were used to evaluate the reliability of the findings.
Finally, a total of 6612 participants were included in our study, consisting of 1005 participants with diagnosis of OAB and 5607 participants without diagnosis of OAB. After adjusting for all covariates, there was a significant positive association between OAB and depression (OR: 2.89, 95 % CI: 1.91, 4.37). The severity of OAB was also positively associated with depression. Compared to participants without OAB, the fully adjusted ORs for depression were 2.76 (95 % CI: 1.64, 4.65) for those with mild OAB, 3.79 (95 % CI: 1.68, 8.55) for those with moderate OAB, and 5.21 (95 % CI: 1.39, 19.53) for those with severe OAB.
This study revealed a strong association between OAB and depression and a progressive increase in the risk of depression as the severity of OAB (mild, moderate, and severe) increased. Therefore, it is important for clinicians to recognize the assessment of OAB symptoms in patients who are at risk for or have developed depressive symptoms, as well as the mental health of patients with OAB.
膀胱过度活动症（OAB）和抑郁症都是常见疾病，有研究表明两者之间存在关联，但缺乏大样本研究。本研究旨在探讨 OAB 与抑郁症状之间的关联。
我们使用了 2005 年至 2018 年期间国家健康和营养检查调查（NHANES）数据库的数据。OAB 的特征是通过膀胱过度活动症症状评分（OABSS，得分>3）来确定，而抑郁症则通过患者健康问卷（PHQ-9，得分≥10）来诊断。我们的分析采用了三种模型：（1）未调整的粗模型；（2）调整了年龄、性别、种族/民族、教育程度和婚姻状况的模型 1；（3）调整了模型 1 中的因素以及剩余潜在协变量的模型 2。我们使用调查加权逻辑回归模型来评估 OAB 与抑郁之间的关联。随后，进行了亚组分析和平滑曲线分析，以评估结果的可靠性。
最终，共有 6612 名参与者纳入了我们的研究，其中 1005 名参与者被诊断为 OAB，5607 名参与者未被诊断为 OAB。在调整了所有协变量后，OAB 与抑郁之间存在显著的正相关（OR：2.89，95%CI：1.91，4.37）。OAB 的严重程度也与抑郁呈正相关。与没有 OAB 的参与者相比，轻度 OAB 患者的抑郁完全调整后的 OR 为 2.76（95%CI：1.64，4.65），中度 OAB 患者为 3.79（95%CI：1.68，8.55），重度 OAB 患者为 5.21（95%CI：1.39，19.53）。
本研究揭示了 OAB 与抑郁之间的强烈关联，并且随着 OAB 严重程度（轻度、中度和重度）的增加，抑郁风险呈递增趋势。因此，临床医生在评估有抑郁症状风险或已患有抑郁症状的患者时，评估 OAB 症状以及 OAB 患者的心理健康状况非常重要。
