title: Anxiety and depression analyses of patients undergoing diagnostic cystoscopy.
abstract: To prospectively assess anxiety and depression in patients undergoing diagnostic cystoscopy.
  
  
  
  Patients presenting for outpatient diagnostic cystoscopy were recruited from four European urological departments. Anxiety and depression were assessed with the 'Hospital Anxiety and Depression Scale' (HADS) before cystoscopy and after 1 week. Statistical analyses, including the Chi-square test, univariate, and multivariate logistic regression analyses, were carried out with SPSS v. 21 (IBM Corp., Armonk, NY).
  
  
  
  Prior to cystoscopy, 30.2 % of patients were anxious and 24.8 % depressive (n = 442). In the post-examination period, anxiety declined to 24.5 %, while depression was unchanged (24.4 %). Pre-cystoscopy anxiety was significantly more common in women (41.8 vs. 24.5 %, p < 0.0001), patients aged <65 years (34.9 vs. 25.9 %, p = 0.04), and in those being examined with rigid cystoscopes (35.7 vs. 23.9 %, p = 0.007). In multivariate regression analyses, female gender (OR 2.6, p < 0.0001), <65 years of age (OR 1.7, p = 0.03), and coexistence of depression (OR 7.8, p < 0.0001) were independently associated with elevated pre-cystoscopy anxiety. Anxious (OR 2.1, p = 0.03) and depressive (OR 2.1, p = 0.01) patients had higher odds of experiencing moderate or severe pain during cystoscopy. Bladder cancer diagnosis did not significantly change patient's anxiety (p = 0.23) or depression (p = 0.7) during the 1 week of follow-up.
  
  
  
  Women, patients aged <65 years, depressive patients and those being examined with rigid devices had higher rates of anxiety prior to cystoscopy. Anxious and depressive patients experienced more pain during cystoscopy. Bladder cancer diagnosis seems to have a minor effect on anxiety and depression during the first week after diagnosis.
authors.affiliation: Department of Urology, Landesklinikum Baden-Mödling, Baden, Austria. st.seklehner@gmx.net.
authors.forename: Stephan
authors.initials: S
authors.lastname: Seklehner
authors.affiliation: Department of Urology, Landesklinikum Baden-Mödling, Baden, Austria.|Department of Urology, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Paul Friedrich
authors.initials: PF
authors.lastname: Engelhardt
authors.affiliation: Department of Urology, Landesklinikum Korneuburg, Korneuburg, Austria.
authors.forename: Mesut
authors.initials: M
authors.lastname: Remzi
authors.affiliation: Department of Urology, Universitätsklinikum Sankt Pölten, St. Pölten, Austria.|Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
authors.forename: Harun
authors.initials: H
authors.lastname: Fajkovic
authors.affiliation: Department of Urology, Klinički Bolnički Centar Split, Split, Croatia.
authors.forename: Zana
authors.initials: Z
authors.lastname: Saratlija-Novakovic
authors.affiliation: Department of Urology, Landesklinikum Korneuburg, Korneuburg, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Skopek
authors.affiliation: Department of Urology, Universitätsklinikum Sankt Pölten, St. Pölten, Austria.
authors.forename: Irene
authors.initials: I
authors.lastname: Resch
authors.affiliation: Department of Urology, Klinički Bolnički Centar Split, Split, Croatia.
authors.forename: Mario
authors.initials: M
authors.lastname: Duvnjak
authors.affiliation: Department of Urology, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Stephan
authors.initials: S
authors.lastname: Hruby
authors.affiliation: Department of Urology, Donauspital Vienna, Vienna, Austria.
authors.forename: Clemens
authors.initials: C
authors.lastname: Wehrberger
authors.affiliation: Department of Urology, Klinički Bolnički Centar Split, Split, Croatia.
authors.forename: Davor
authors.initials: D
authors.lastname: Librenjak
authors.affiliation: Department of Urology, Landesklinikum Korneuburg, Korneuburg, Austria.
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Hübner
authors.affiliation: Department of Urology, Universitätsklinikum Sankt Pölten, St. Pölten, Austria.
authors.forename: Eckart
authors.initials: E
authors.lastname: Breinl
authors.affiliation: Department of Urology, Landesklinikum Baden-Mödling, Baden, Austria.
authors.forename: Claus
authors.initials: C
authors.lastname: Riedl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis* / Q000523:psychology; D003558:Cystoscopy / Q000379:methods / Q000523:psychology*; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D055815:Young Adult
keywords: Anxiety; Cystoscopy; Depression; Diagnostic techniques, urological; Pain