title: Severe depression determines quality of life in urinary incontinent women.
abstract: OBJECTIVE
  The purpose of this study was to assess depression and anxiety in urinary incontinent women and to investigate factors influencing their self-perception of urinary incontinence severity.
  
  
  METHODS
  In this prospective study, 82 incontinent women estimated the severity of urinary incontinence using a visual analogue scale and completed a validated quality of life instrument: urinary incontinence severity score. Psychiatrists evaluated depression and anxiety using a structured interview of Hamilton Depression and Hamilton Anxiety Scales. Patients were classified on the basis of history and urodynamic evaluation into two diagnostic groups: stress urinary incontinence (n = 57) and idiopatic urge incontinence with or without stress incontinence (n = 25).
  
  
  RESULTS
  Major depression occurred in 44.0% of women with idiopatic urge (+/- stress) incontinence and in 17.5% women with stress incontinence (odds ratio (OR 3.69), 95% confidence interval (95% CI 1.30-10.49)). Twenty two patients had severe incontinence defined as Urinary Incontinence Severity Score > or =14 points (upper quartile) and 23 patients defined as visual analogue scale > or =9 (upper quartile). In logistic regression analysis, major depression (OR 5.57; 95% CI 1.19-26.11), urge incontinence diagnosis (OR 23.13; 95% CI 1.90-282.11), parity (OR 2.33; 95% CI 1.16-4.60) and high Urgency Score (OR 1.94; 95% CI 1.32-2.85) predicted Urinary Incontinence Severity Score above the upper quartile. Only the pad-test (OR 1.01; 95% CI 1.00-1.02) predicted visual analogue scale above upper quartile.
  
  
  CONCLUSIONS
  Major depression correlates with reduced incontinence specific quality of life. This data also suggests an association between depression and idiopatic urge incontinence.
authors.affiliation: Department of Obstetrics and Gynaecology, Tampere University Hospital, Tampere, Finland. beata.stach-lempinen@fimnet.fi
authors.forename: Beatas
authors.initials: B
authors.lastname: Stach-Lempinen
authors.forename: Asta-Leena
authors.initials: AL
authors.lastname: Hakala
authors.forename: Pekka
authors.initials: P
authors.lastname: Laippala
authors.forename: Klaus
authors.initials: K
authors.lastname: Lehtinen
authors.forename: Riina
authors.initials: R
authors.lastname: Metsänoja
authors.forename: Erkki
authors.initials: E
authors.lastname: Kujansuu
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D003865:Major Depressive Disorder / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000150:complications / Q000523:psychology*; D014550:Urinary Incontinence, Stress / Q000523:psychology; D014563:Urodynamics / Q000502:physiology