title: Prevalence of anxiety and depressive symptoms and their association with pelvic floor dysfunctions-A cross sectional cohort study at a Pelvic Care Centre.
abstract: OBJECTIVE
  Pelvic floor dysfunctions (PFDs), like voiding complaints, urinary and fecal incontinence, and prolapse, are prevalent and associated with decrease in quality of life. PFDs are often complex and multifactorial in origin showing interrelationships between different PFD and with affective conditions. The primary aim of this study is to describe the prevalence of affective complaints in a cohort of Pelvic Care Centre (PCC) patients. The secondary aim is to describe associations between PFDs and depression or anxiety.
  
  
  METHODS
  A cross sectional cohort study at an University Hospital's PCC. First contact patients were included in a triage system and filled out questionnaires regarding pelvic floor complaints and Hospital Anxiety and Depression Scale (HADS) scores. Linear (dummy-) regression analysis of HADS scales was performed to test the effects of relevant clinical predictors related, and not directly related, to pelvic floor problems, and demographic characteristics of the patients.
  
  
  RESULTS
  From 1862 eligible first-contact PCC patients, 1510 (mean age 57.1) had completed the questionnaire (352 missing, 18.9%). The prevalence of anxiety and depression complaints was 30.9% and 20.3%, respectively. The variance explained for depression score by PFDs was 0.12 and 0.074 for anxiety.
  
  
  CONCLUSIONS
  Anxiety and depression are prevalent (30.9% and 20.3%, respectively) in a cohort of PFDs. PFDs can explain variance within anxiety and depression complaints. Corrected for other contributing variables, 12% of depression and 7.4% of anxiety was directly related to PFDs. We advocate a multidisciplinary approach, containing psychometric assessment for PFDs in order to obtain better diagnostic results and personalized treatment options.
authors.affiliation: Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.|Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Desiree
authors.initials: D
authors.lastname: Vrijens
authors.affiliation: Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Bary
authors.initials: B
authors.lastname: Berghmans
authors.affiliation: Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Fred
authors.initials: F
authors.lastname: Nieman
authors.affiliation: Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands.|King's Health Partners, Institute of Psychiatry, King's College London, London, United Kingdom.|MeHNS, Research School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
authors.forename: Jim
authors.initials: J
authors.lastname: van Os
authors.affiliation: Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.|Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands.|MeHNS, Research School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
authors.forename: Gommert
authors.initials: G
authors.lastname: van Koeveringe
authors.affiliation: Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.|Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands.|MeHNS, Research School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
authors.forename: Carsten
authors.initials: C
authors.lastname: Leue
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology*; D059952:Pelvic Floor Disorders / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D015995:Prevalence; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: anxiety; depression; fecal incontinence; pelvic floor dysfunction; pelvic organ prolapse; urinary incontinence