Depressive symptoms and treatment of women with urgency urinary incontinence

Rachel Kafri; Arad Kodesh; Jeffrey Shames; Jacob Golomb; Itshak Melzer

doi:10.1007/s00192-013-2116-9

Depressive symptoms and treatment of women with urgency urinary incontinence

Rachel Kafri, Arad Kodesh, Jeffrey Shames, Jacob Golomb, Itshak Melzer

Department of Community Mental Health

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction and hypothesis: Depression is more common in patients with urinary incontinence (UI). Drug or rehabilitation therapy have been shown to be effective in reducing urgency UI (UUI) symptoms, but whether these treatments can ameliorate the negative impact of UUI on the psychological aspects of quality of life is unclear. Methods: A secondary analysis of an assessor-blinded randomized controlled trial was performed. The number of depressive symptoms was the primary outcome as measured by the Center for Epidemiologic Studies Depression scale (CES-D). Results: Thirty-six (22 %) subjects had a CES-D score >16 at baseline, the cutoff for having depressive symptoms. A significant association was found between having a CES-D score >16 and lower quality of life related to UI at baseline. The mean CES-D score among those with depressive symptoms at baseline was significantly reduced throughout the study, with a mean of 23.7 at baseline, to 18.3 and 15.2 at the 3-month and 1-year follow-up (p < 0.001), respectively. The number of participants who had depressive symptoms decreased during the study period only in the physical therapy groups, from 31 at baseline to 28 and 25, at 3 and 12 months, respectively, while there was no such change in the drug group. Conclusions: Patients with UUI who had depressive symptoms showed significant improvement in their depressive symptoms with treatment over 1 year. This improvement occurred regardless of the type of treatment. This study emphasizes the increasingly recognized problem of undiagnosed depression among middle-aged women with UUI.

Original language	English
Pages (from-to)	1953-1959
Number of pages	7
Journal	International Urogynecology Journal
Volume	24
Issue number	11
DOIs	https://doi.org/10.1007/s00192-013-2116-9
State	Published - Nov 2013

Bibliographical note

Funding Information:
Acknowledgments We thank the physical therapists of Maccabi Healthcare Services who specialize in pelvic floor rehabilitation and their clinic directors for participating in the study and managing the data collection process. We thank the managers of the Maccabi ‘Ramot’ clinic and their team and the management of Shefela – Jerusalem District for their support of this project. We also thank the gynecology and urogynecology physicians who referred patients to our study and managed the drug therapy group. A special acknowledgment is dedicated to Dr. Yossi Azuri, M.D., MHA, head of the Clinical Studies Unit in Maccabi Healthcare Services and his staff. We thank Daniel Deutscher, Ph.D. PT, Director of Research and Development, Physical Therapy Service, Maccabi Healthcare Services, Tel Aviv, Israel. This study was funded by Maccabbi Healthcare services in Israel.

Keywords

Center for Epidemiologic Studies Depression scale (CES-D)
Depressive symptoms
Drug therapy
Pelvic floor muscle training
Pelvic floor physical therapy
Urgency urinary incontinence

ASJC Scopus subject areas

Obstetrics and Gynecology
Urology

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10.1007/s00192-013-2116-9

Cite this

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title = "Depressive symptoms and treatment of women with urgency urinary incontinence",

abstract = "Introduction and hypothesis: Depression is more common in patients with urinary incontinence (UI). Drug or rehabilitation therapy have been shown to be effective in reducing urgency UI (UUI) symptoms, but whether these treatments can ameliorate the negative impact of UUI on the psychological aspects of quality of life is unclear. Methods: A secondary analysis of an assessor-blinded randomized controlled trial was performed. The number of depressive symptoms was the primary outcome as measured by the Center for Epidemiologic Studies Depression scale (CES-D). Results: Thirty-six (22 %) subjects had a CES-D score >16 at baseline, the cutoff for having depressive symptoms. A significant association was found between having a CES-D score >16 and lower quality of life related to UI at baseline. The mean CES-D score among those with depressive symptoms at baseline was significantly reduced throughout the study, with a mean of 23.7 at baseline, to 18.3 and 15.2 at the 3-month and 1-year follow-up (p < 0.001), respectively. The number of participants who had depressive symptoms decreased during the study period only in the physical therapy groups, from 31 at baseline to 28 and 25, at 3 and 12 months, respectively, while there was no such change in the drug group. Conclusions: Patients with UUI who had depressive symptoms showed significant improvement in their depressive symptoms with treatment over 1 year. This improvement occurred regardless of the type of treatment. This study emphasizes the increasingly recognized problem of undiagnosed depression among middle-aged women with UUI.",

keywords = "Center for Epidemiologic Studies Depression scale (CES-D), Depressive symptoms, Drug therapy, Pelvic floor muscle training, Pelvic floor physical therapy, Urgency urinary incontinence",

author = "Rachel Kafri and Arad Kodesh and Jeffrey Shames and Jacob Golomb and Itshak Melzer",

note = "Funding Information: Acknowledgments We thank the physical therapists of Maccabi Healthcare Services who specialize in pelvic floor rehabilitation and their clinic directors for participating in the study and managing the data collection process. We thank the managers of the Maccabi {\textquoteleft}Ramot{\textquoteright} clinic and their team and the management of Shefela – Jerusalem District for their support of this project. We also thank the gynecology and urogynecology physicians who referred patients to our study and managed the drug therapy group. A special acknowledgment is dedicated to Dr. Yossi Azuri, M.D., MHA, head of the Clinical Studies Unit in Maccabi Healthcare Services and his staff. We thank Daniel Deutscher, Ph.D. PT, Director of Research and Development, Physical Therapy Service, Maccabi Healthcare Services, Tel Aviv, Israel. This study was funded by Maccabbi Healthcare services in Israel.",

year = "2013",

month = nov,

doi = "10.1007/s00192-013-2116-9",

language = "English",

volume = "24",

pages = "1953--1959",

journal = "International Urogynecology Journal",

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AU - Kafri, Rachel

AU - Kodesh, Arad

AU - Shames, Jeffrey

AU - Golomb, Jacob

AU - Melzer, Itshak

N1 - Funding Information: Acknowledgments We thank the physical therapists of Maccabi Healthcare Services who specialize in pelvic floor rehabilitation and their clinic directors for participating in the study and managing the data collection process. We thank the managers of the Maccabi ‘Ramot’ clinic and their team and the management of Shefela – Jerusalem District for their support of this project. We also thank the gynecology and urogynecology physicians who referred patients to our study and managed the drug therapy group. A special acknowledgment is dedicated to Dr. Yossi Azuri, M.D., MHA, head of the Clinical Studies Unit in Maccabi Healthcare Services and his staff. We thank Daniel Deutscher, Ph.D. PT, Director of Research and Development, Physical Therapy Service, Maccabi Healthcare Services, Tel Aviv, Israel. This study was funded by Maccabbi Healthcare services in Israel.

PY - 2013/11

Y1 - 2013/11

N2 - Introduction and hypothesis: Depression is more common in patients with urinary incontinence (UI). Drug or rehabilitation therapy have been shown to be effective in reducing urgency UI (UUI) symptoms, but whether these treatments can ameliorate the negative impact of UUI on the psychological aspects of quality of life is unclear. Methods: A secondary analysis of an assessor-blinded randomized controlled trial was performed. The number of depressive symptoms was the primary outcome as measured by the Center for Epidemiologic Studies Depression scale (CES-D). Results: Thirty-six (22 %) subjects had a CES-D score >16 at baseline, the cutoff for having depressive symptoms. A significant association was found between having a CES-D score >16 and lower quality of life related to UI at baseline. The mean CES-D score among those with depressive symptoms at baseline was significantly reduced throughout the study, with a mean of 23.7 at baseline, to 18.3 and 15.2 at the 3-month and 1-year follow-up (p < 0.001), respectively. The number of participants who had depressive symptoms decreased during the study period only in the physical therapy groups, from 31 at baseline to 28 and 25, at 3 and 12 months, respectively, while there was no such change in the drug group. Conclusions: Patients with UUI who had depressive symptoms showed significant improvement in their depressive symptoms with treatment over 1 year. This improvement occurred regardless of the type of treatment. This study emphasizes the increasingly recognized problem of undiagnosed depression among middle-aged women with UUI.

AB - Introduction and hypothesis: Depression is more common in patients with urinary incontinence (UI). Drug or rehabilitation therapy have been shown to be effective in reducing urgency UI (UUI) symptoms, but whether these treatments can ameliorate the negative impact of UUI on the psychological aspects of quality of life is unclear. Methods: A secondary analysis of an assessor-blinded randomized controlled trial was performed. The number of depressive symptoms was the primary outcome as measured by the Center for Epidemiologic Studies Depression scale (CES-D). Results: Thirty-six (22 %) subjects had a CES-D score >16 at baseline, the cutoff for having depressive symptoms. A significant association was found between having a CES-D score >16 and lower quality of life related to UI at baseline. The mean CES-D score among those with depressive symptoms at baseline was significantly reduced throughout the study, with a mean of 23.7 at baseline, to 18.3 and 15.2 at the 3-month and 1-year follow-up (p < 0.001), respectively. The number of participants who had depressive symptoms decreased during the study period only in the physical therapy groups, from 31 at baseline to 28 and 25, at 3 and 12 months, respectively, while there was no such change in the drug group. Conclusions: Patients with UUI who had depressive symptoms showed significant improvement in their depressive symptoms with treatment over 1 year. This improvement occurred regardless of the type of treatment. This study emphasizes the increasingly recognized problem of undiagnosed depression among middle-aged women with UUI.

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KW - Pelvic floor muscle training

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Depressive symptoms and treatment of women with urgency urinary incontinence

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

Access to Document

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