Major depression drives severity of American Urological Association Symptom Index.
OBJECTIVE
To evaluate the unclear relationship between depression and benign prostatic hyperplasia (BPH) by assessing depression's effect on the American Urological Association Symptom Index (AUA-SI) scores. Depression is a common illness associated with chronic inflammatory disease states. Data have suggested a significant role of inflammation in the progression of BPH.


METHODS
The present prospective study involved 547 male patients who completed the Geriatric Depression Scale and the AUA-SI. We evaluated whether the mean AUA-SI score and the severity categories differed by the state of depression. We then conducted binary logistic regression analysis with forward stepwise regression to assess the relationship between depression and the severity symptoms as determined by the AUA-SI score.


RESULTS
Of the cohort, 22% screened positive for depressive symptoms. The depressed patients (Geriatric Depression Scale score >5) reported significantly more severe symptoms (mean AUA-SI score 16.61 ± 9.89) compared with the nondepressed patients (Geriatric Depression Scale score of ≤5 and mean AUA-SI score 10.65 ± 7.29; F = 40.19, P <.001). After controlling for socioeconomic and demographic variables, depressed patients were 3 times more likely to present with severe symptoms (odds ratio 3.079, 95% confidence interval 1.129-8.402, P = .028).


CONCLUSIONS
A significant association was found between depression and BPH. However, it remains unclear whether this relationship represents unidirectional or bidirectional causality. Additional research is imperative to assess the nature of this correlation, either to address comorbid depression in patients with BPH or to ensure that depressed patients do not report falsely elevated symptoms.
Department of Urology, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Timothy V
TV
Johnson
Ammara
A
Abbasi
Samantha S
SS
Ehrlich
Renee S
RS
Kleris
Siri L
SL
Chirumamilla
Evan D
ED
Schoenberg
Ashli
A
Owen-Smith
Charles L
CL
Raison
Viraj A
VA
Master
D000328:Adult; D000368:Aged; D015984:Causality; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D007249:Inflammation / Q000453:epidemiology* / Q000523:psychology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011470:Prostatic Hyperplasia / Q000453:epidemiology* / Q000523:psychology; D012720:Severity of Illness Index; D012959:Socioeconomic Factors