본문 바로가기
KERD
논문KCI 등재

Men With Severe Lower Urinary Tract Symptoms Are at Increased Risk of Depression

최보율|남지원|문홍상|김신아|김규식|최홍용|정원식
대한배뇨장애요실금학회 (Korean Continence Society)|2015.12|International Neurourology Journal|제19권 제4호|pp. 286-292

2

조회

0

다운로드

7

인용

0

참고문헌

키워드

DepressionLower Urinary Tract SymptomsProstatic Hyperplasia

초록

Purpose: Lower urinary tract symptoms (LUTS) comprise a set of common, bothersome symptoms in middle-aged and elderly men. Recent research suggests that depressive symptoms may influence the symptoms of benign prostatic hyperplasia (BPH). We performed a community-based cross-sectional study to evaluate the correlation between LUTS and depression. Methods: The survey was conducted in a rural community during four periods in August 2009, 2010, 2011, and 2012. Two validated questionnaires were used to examine LUTS and depressive symptoms. These included the International Prostate Symptom Score/quality of life (IPSS/QoL) and the Korean version of the Center for Epidemiological Studies-Depression scale (CES-D-K). Patients were categorized in the depressive symptom group if their CES-D-K score was >16 points. Results: A total of 711 men were included in this study. Thirty-five participants (4.92%) were found to have depressive symptoms. There was a positive correlation between depressive symptoms and LUTS severity (P<0.001). As compared to the mild LUTS group, the odds ratio (OR) of depression was 2.868 (95% confidence interval [CI], 1.293–6.362; P for trend<0.001) in the moderate LUTS group, and 4.133 (95% CI, 1.510–11.313; P for trend<0.001) in the severe LUTS group. In a model considering multiple variables such as age, education level, smoking, and exercise, the OR in the moderate LUTS group was 2.534 (1.125–5.708, 95% CI, P for trend=0.005), while that in the severe LUTS group was 3.910 (95% CI, 5.708–11.154; P for trend=0.005). In addition, depression was related to voiding symptoms. Conclusions: Men with severe LUTS are at higher risk of depression than those with less severe urinary symptoms. The severity of voiding symptoms worsens depression. More aggressive urological diagnosis and treatment is needed in patients with severe LUTS, due to the impact on depressive symptoms and QoL.

Abstract

Purpose: Lower urinary tract symptoms (LUTS) comprise a set of common, bothersome symptoms in middle-aged and elderly men. Recent research suggests that depressive symptoms may influence the symptoms of benign prostatic hyperplasia (BPH). We performed a community-based cross-sectional study to evaluate the correlation between LUTS and depression. Methods: The survey was conducted in a rural community during four periods in August 2009, 2010, 2011, and 2012. Two validated questionnaires were used to examine LUTS and depressive symptoms. These included the International Prostate Symptom Score/quality of life (IPSS/QoL) and the Korean version of the Center for Epidemiological Studies-Depression scale (CES-D-K). Patients were categorized in the depressive symptom group if their CES-D-K score was >16 points. Results: A total of 711 men were included in this study. Thirty-five participants (4.92%) were found to have depressive symptoms. There was a positive correlation between depressive symptoms and LUTS severity (P<0.001). As compared to the mild LUTS group, the odds ratio (OR) of depression was 2.868 (95% confidence interval [CI], 1.293–6.362; P for trend<0.001) in the moderate LUTS group, and 4.133 (95% CI, 1.510–11.313; P for trend<0.001) in the severe LUTS group. In a model considering multiple variables such as age, education level, smoking, and exercise, the OR in the moderate LUTS group was 2.534 (1.125–5.708, 95% CI, P for trend=0.005), while that in the severe LUTS group was 3.910 (95% CI, 5.708–11.154; P for trend=0.005). In addition, depression was related to voiding symptoms. Conclusions: Men with severe LUTS are at higher risk of depression than those with less severe urinary symptoms. The severity of voiding symptoms worsens depression. More aggressive urological diagnosis and treatment is needed in patients with severe LUTS, due to the impact on depressive symptoms and QoL.

참고문헌 (33)

  1. Ustun TB, "Global burden of depressive disorders in the year 2000", Br J Psychiatry, 184, pp.386~392 (2004)
  2. 전홍진, "우울증과 자살 역학연구", 대한의사협회지, 55(4), pp.322~328 (2012), 대한의사협회[DOI]
  3. 문홍상, "배뇨장애와 우울증과의 연관성", Hanyang Medical Reviews, 34(2), pp.87~90 (2014), 한양대학교 의과대학[DOI]
  4. Berry SJ, "The development of human benign prostatic hyperplasia with age", J Urol, 132, pp.474~479 (1984)
  5. Parsons JK, "Prevalence and characteristics of lower urinary tract symptoms in men aged > or=80 years", Urology, 72, pp.318~321 (2008)
  6. Parsons JK, "Benign prostatic hyperplasia and male lower urinary tract symptoms: epidemiology and risk factors", Curr Bladder Dysfunct Rep, 5, pp.212~218 (2010)
  7. Abrams P, "International Consultation on New Developments in Prostate Cancer and Prostate Diseases. Evaluation and treatment of lower urinary tract symptoms in older men", J Urol, 189(1 Suppl), pp.S93~S101 (2013)
  8. Speakman MJ, "Lower urinary tract symptoms suggestive of benign prostatic obstruction: what is the available evidence for rational management", Eur Urol, 39(Suppl 3), pp.6~12 (2001)
  9. Eduardo de Paula Miranda, "Nocturia is the Lower Urinary Tract Symptom With Greatest Impact on Quality of Life of Men From a Community Setting", International Neurourology Journal, 18(2), pp.86~90 (2014), 대한배뇨장애요실금학회
  10. van Moorselaar J, "LUTS and sexual dysfunction: implication for management of BPH", Eur Urol Suppl, 2, pp.13~20 (2003)
  11. Abdulmaged M. Traish, "The Dark Side of 5α-Reductase Inhibitors’ Therapy: Sexual Dysfunction, High Gleason Grade Prostate Cancer and Depression", Investigative and Clinical Urology, 55(6), pp.367~379 (2014), 대한비뇨기과학회
  12. Roehrborn CG, "ARIA3001 ARIA3002 and ARIA3003 Study Investigators. Efficacy and safety of a dual inhibitor of 5-alpha-reductase types 1 and 2 (dutasteride) in men with benign prostatic hyperplasia", Urology, 60, pp.434~441 (2002)
  13. Andersson KE, "Ejaculatory dysfunction: why all alphablockers are not equal", BJU Int, 92, pp.876~877 (2003)
  14. 송효정, "Impact of Lower Urinary Tract Symptoms and Depression on Health-Related Quality of Life in Older Adults", International Neurourology Journal, 16(3), pp.132~138 (2012), 대한배뇨장애요실금학회[DOI]
  15. Radloff LS, "The CES-D scale: a self-report depression scale for research in the general population", Appl Psychol Meas, 1, pp.385~401 (1977)
  16. Cho MJ, "Diagnostic validity of the CES-D(Korean version) in the assessment of DSM-III-R major depression", J Korean Neuropsychiatr Assoc, 32, pp.381~399 (1993)
  17. 박준혁, "한국의 우울증 역학에 대한 고찰", 대한의사협회지, 54(4), pp.362~369 (2011), 대한의사협회
  18. 오동훈, "Prevalence and Correlates of Depressive Symptoms in Korean Adults : Results of a 2009 Korean Community Health Survey", Journal of Korean Medical Science, 28(1), pp.128~135 (2013), 대한의학회
  19. 권춘식, "Prevalence, Risk Factors, Quality of Life, and Health-Care Seeking Behaviors of Female Urinary Incontinence: Results From the 4th Korean National Health and Nutrition Examination Survey VI (2007–2009)", International Neurourology Journal, 18(1), pp.31~36 (2014), 대한배뇨장애요실금학회
  20. Zorn BH, "Urinary incontinence and depression", J Urol, 162, pp.82~84 (1999)
  21. Melville JL, "Major depression and urinary incontinence in women: temporal associations in an epidemiologic sample", Am J Obstet Gynecol, 201(490), pp.e1~e7 (2009)
  22. Lung-Cheng Huang C, "The association of healthcare seeking behavior for anxiety and depression among patients with lower urinary tract symptoms: a nationwide population-based study", Psychiatry Res, 226, pp.247~251 (2015)
  23. Eckhardt MD, "Prevalence and bothersomeness of lower urinary tract symptoms in benign prostatic hyperplasia and their impact on well-being", J Urol, 166, pp.563~568 (2001)
  24. Gannon K, "Lower urinary tract symptoms in men: self-perceptions and the concept of bother", BJU Int, 96, pp.823~827 (2005)
  25. Glover L, "Men’s experiences of having lower urinary tract symptoms: factors relating to bother", BJU Int, 94, pp.563~567 (2004)
  26. Huang CY, "Increased risk of depressive disorder following the diagnosis of benign prostatic enlargement: one-year follow-up study", J Affect Disord, 135, pp.395~399 (2011)
  27. Johnson TV, "Major depression drives severity of American Urological Association Symptom Index", Urology, 76, pp.1317~1320 (2010)
  28. Marschall-Kehrel D, "Update on nocturia: the best of rest is sleep", Urology, 64(6 Suppl 1), pp.21~24 (2004)
  29. Rom M, "Lower urinary tract symptoms and depression", BJU Int, 110(11 Pt C), pp.E918~E921 (2012)
  30. Breyer BN, "The association of lower urinary tract symptoms, depression and suicidal ideation: data from the 2005-2006 and 2007-2008 National Health and Nutrition Examination Survey", J Urol, 191, pp.1333~1339 (2014)
  31. Pietrzyk B, "Depressive symptoms in patients diagnosed with benign prostatic hyperplasia", Int Urol Nephrol, 47, pp.431~440 (2015)
  32. Wong SY, "Lower urinary tract symptoms and depressive symptoms in elderly men", Affect Disord, 96, pp.83~88 (2006)
  33. Wong SY, "Depressive symptoms and lifestyle factors as risk factors of lower urinary tract symptoms in Southern Chinese men: a prospective study", Aging Male, 13, pp.113~119 (2010)

이 간행물의 다른 논문 (12건)

The Role of OnabotulinumtoxinA in Urology: What Is the Next Step?문홍상pp. 211-212Practical Aspects of Botulinum Toxin-A Treatment in Patients With Overactive Bladder SyndromeHann-Chorng Kuo, Chun-Hou Liaopp. 213-219Effects of Modafinil on Behavioral Learning and Hippocampal Synaptic Transmission in RatsPeng Xiao, Wen-Wen Yan, Li-Hua Yao, Hai-Xia Wang, Chu-Hua Li, Jun-Ni Huang, Cheng-Yi Liu, Chong Chenpp. 220-227Alpha1-Adrenoceptor Antagonists Improve Memory by Activating N-Methyl-D-Aspartate-Induced Ion Currents in the Rat Hippocampus신기문, 김계환, 조정완, 강연호, 신말순, 고일규, 김창희, 김성은, 임백빈, 김창주pp. 228-236A Meta-Analysis of Long- Versus Short-Acting Phosphodiesterase 5 Inhibitors: Comparing Combination Use With α-Blockers and α-Blocker Monotherapy for Lower Urinary Tract Symptoms and Erectile Dysfunction문두건, 김현정, 배재현, 여정균, 김재헌, 천준, 최훈pp. 237-245
원문 보기