title: Effect of biofeedback on psychological burden and symptoms in older women with urge urinary incontinence.
abstract: OBJECTIVE
  To determine the effect of biofeedback (BFB) therapy on psychological burden of urge urinary incontinence (UI) and whether prior depression or current depressive symptoms affect older women's response to BFB.
  
  
  METHODS
  Secondary analysis of an ongoing trial.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Forty-two community-dwelling women aged 60 and older with urge UI.
  
  
  METHODS
  BFB and behavioral training in urge suppression provided over 8 weeks.
  
  
  METHODS
  UI frequency on 3-day bladder diary, psychological burden assessed using Urge Impact Scale (URIS-24) total and subscale scores, history of depression, and depressive symptoms on the Mental Component Subscale (MCS) of the Medical Outcomes Study 36-item Short Form Survey (SF-36). Age and chronic conditions were included as covariates.
  
  
  RESULTS
  BFB improved UI (by 45%, P=.001) and psychological burden (P=.001 for total URIS-24 score and for all three of its subscales; P=.01 for SF36-MCS). However, although the magnitude of UI improvement was equivalent for those with and without a history of depression, improvement in psychological outcomes was twice as great in those with a history of depression, especially on the perception of control subscale, and improvement was not related to baseline depressive symptoms.
  
  
  CONCLUSIONS
  In older women with urge UI, BFB significantly improves psychological burden, especially in those with a history of depression, in whom psychological burden is linked to change in perception of control. Psychological factors are relevant outcome measures for UI, and these data suggest that focusing on UI frequency alone may have underestimated BFB's efficacy and additional therapeutic benefits.
authors.affiliation: Division of Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. tadics@upmc.edu
authors.forename: Stasa D
authors.initials: SD
authors.lastname: Tadic
authors.forename: Bozena
authors.initials: B
authors.lastname: Zdaniuk
authors.forename: Derek
authors.initials: D
authors.lastname: Griffiths
authors.forename: Lisa
authors.initials: L
authors.lastname: Rosenberg
authors.forename: Werner
authors.initials: W
authors.lastname: Schäfer
authors.forename: Neil M
authors.initials: NM
authors.lastname: Resnick
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001676:Biofeedback, Psychology; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000523:psychology* / Q000628:therapy*