Jeney Sarah E S, Ford Cassie B, Wu Jennifer M, Sheyn David, Gregory W Thomas
From the Department of Obstetrics and Gynecology, Division of Urogynecology, University of New Mexico Health Sciences Center, Albuquerque, NM.
Department of Population Health Sciences, Duke University, Durham, NC.
Urogynecology (Phila). 2025 May 13. doi: 10.1097/SPV.0000000000001696.
The incidence of and factors associated with psychotherapy use in women with overactive bladder are unknown.
The primary objectives of this study were to determine the incidence of psychotherapy initiation after overactive bladder diagnosis in female Medicare beneficiaries and to analyze clinical and sociodemographic factors associated with initiation of psychotherapy within 3 years from overactive bladder (OAB) diagnosis.
This was a retrospective cohort study of women diagnosed with OAB between the years 2011 and 2021 using the Medicare 5% Limited Data Set. International Classification of Diseases codes were used to identify women with OAB, and from that cohort, Current Procedural Terminology codes were used to identify incident use of psychotherapy within 5 years from OAB diagnosis. Cox proportional hazards models were used to evaluate clinical and sociodemographic factors associated with the use of psychotherapy. Logistic regression was used to evaluate clinical and sociodemographic factors associated with high (≥10 sessions) versus low (<10 sessions) utilization of psychotherapy.
There were 374,918 women who met the inclusion criteria for OAB diagnosis; of these, 28,571 (8.7%) attended at least 1 psychotherapy session within 5 years. Factors associated with the increased use of psychotherapy included dual Medicaid/Medicare status (adjusted odds ratio [aOR] 1.26 [1.21, 1.31]), living in the Northeast (vs South) (aOR 1.26 [1.21, 1.31]), being diagnosed with anxiety or depression (aOR 5.14 [5.01, 5.26]), alcohol or drug abuse (aOR 1.66 [1.57, 1.75]), and increasing Charlson comorbidity score (aOR 1.03 [1.03, 1.04]).
Psychotherapy use in older women with OAB is not rare. Demographic factors and psychiatric comorbidities affect the likelihood of psychotherapy use in this population.
膀胱过度活动症女性患者接受心理治疗的发生率及相关因素尚不清楚。
本研究的主要目的是确定女性医疗保险受益人中膀胱过度活动症诊断后开始心理治疗的发生率，并分析膀胱过度活动症（OAB）诊断后3年内与开始心理治疗相关的临床和社会人口统计学因素。
这是一项回顾性队列研究，使用医疗保险5%有限数据集对2011年至2021年期间被诊断为OAB的女性进行研究。使用国际疾病分类代码识别患有OAB的女性，并从该队列中，使用当前程序术语代码识别OAB诊断后5年内心理治疗的首次使用情况。使用Cox比例风险模型评估与心理治疗使用相关的临床和社会人口统计学因素。使用逻辑回归评估与心理治疗高（≥10次疗程）与低（<10次疗程）使用相关的临床和社会人口统计学因素。
有374918名女性符合OAB诊断的纳入标准；其中，28571名（8.7%）在5年内至少参加了1次心理治疗疗程。与心理治疗使用增加相关的因素包括双重医疗补助/医疗保险状态（调整优势比[aOR]1.26[1.21，1.31]）、居住在东北部（与南部相比）（aOR 1.26[1.21，1.31]）、被诊断患有焦虑或抑郁（aOR 5.14[5.01，5.26]）、酒精或药物滥用（aOR 1.66[1.57，1.75]）以及Charlson合并症评分增加（aOR 1.03[1.03，1.04]）。
老年OAB女性使用心理治疗并不罕见。人口统计学因素和精神疾病共病影响该人群使用心理治疗的可能性。
