Original scientific paper
LOWER URINARY TRACT SYMPTOMS AND DEPRESSION IN PATIENTS WITH MULTIPLE SCLEROSIS
Katarina Ivana Tudor
; Department of Neurology, Unit for Headaches, Neurogenic Pain and Spinal Disorders, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
Marija Bošnjak Pašić
; eferral Center for Demyelinating Diseases of the Central Nervous System, Unit for Neuroimmunology of Central Nervous System, Clinical Department of Neurology, University Hospital Center Zagreb, Zagreb, Croatia; School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Sandra Nađ Škegro
; Department of Urology, School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
Mirko Bakula
; Department of Urology, School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
Jakob Nemir
; Department of Neurosurgery, School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
Filip Mustač
; University of Zagreb, School of Medicine (Medical Studies in English), Zagreb, Croatia (student); The Croatian Institute of Emergency Medicine, Zagreb County, Croatia
Branka Vidrih
; Department of Psychiatry, University Hospital Centre Sisters of Mercy, Catholic University of Croatia, Zagreb, Croatia
Hanna Pašić
; University of Zagreb, School of Medicine (Medical Studies in English), Zagreb, Croatia (student)
Luka Vujević
; University of Zagreb, School of Medicine (Medical Studies in English), Zagreb, Croatia (student)
Fabijan Rajič
; Croatian Football Federation, Zagreb Football Association, Zagreb, Croatia
Lorainne Tudor Car
; Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom; Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
Abstract
Background: Both depression and lower urinary tract symptoms (LUTS) may be present in patients with multiple sclerosis (MS).
The objective of this study was to give an insight on depression and LUTS in patients with MS in Croatia and to determine the
possible association between LUTS and depression in patients with MS.
Subjects and methods: This was a prospective cross-sectional study conducted in a tertiary healthcare center in Croatia. Hundred
and one consecutive patients with MS (75 female, 26 male, mean age 42.09 (range 19-77) years, mean Expanded Disability Status
Scale (EDSS) score 3.1 (range 0.0-7.0)) participated in this study. We evaluated LUTS and related quality of life (QoL) using three International
Consultation on Incontinence Questionnaires (ICIQ) enquiring about overactive bladder (ICIQ-OAB), urinary incontinence
short form (ICIQ-UI SF) and lower urinary tract symptoms related quality of life (ICIQLUTS-QoL). ICIQ-OAB and ICIQLUTS-QoL
were for this purpose with permission successfully translated and validated into Croatian, while ICIQ-UI SF was already previously
validated for the Croatian language. Information regarding treatment for depression was obtained during the medical interview. Data
were analyzed and interpreted using IBM SPSS Statistics for Windows, version 23.0 (IBM Corp., Armonk, N.Y., USA).
Results: 89.10% (N=90) patients with MS reported urgency with urge urinary incontinence (UUI) present in 70.29% (N=71).
81.18% (N=82) patients reported nocturia, and 90.09% (N=91) reported feeling drowsy or sleepy during the day due to bladder
symptoms. Neurological deficit measured by EDSS was found to positively correlate with LUTS on all three questionnaires: ICIQOAB
(r=0.390, p<0.05), ICIQ-UI SF (r=0.477, p<0.01) and ICIQ-LUTSQoL (r=0.317, p<0.05). 25 patients were in treatment for
depression. There were no significant differences between female and male patients regarding treatment for depression (2=0.018, df=1, p>0.05). Results on ICIQ-UI SF showed that depressive patients had more pronounced LUTS (t=2.067, df=99, p<0.05), which was also true for the ICIQ-LUTSQoL (t=-2.193, df=99, p<0.05). Positive correlations were found between depression and LUTS on ICIQ-UI SF (r=0.203, p<0.05) and ICIQ-LUTSQoL (r=0.215, p<0.05).
Conclusion: This study gives insight into the presence of depression and LUTS in Croatian patients with MS for which purpose
ICIQ-OAB and ICIQ-LUTSQoL were with permission successfully translated and validated into Croatian. The connection between depression and LUTS must be considered when managing patients with MS.
Keywords
lower urinary tract symptoms (LUTS); depression; multiple sclerosis (MS); International Consultation on Incontinence Questionnaires (ICIQ); overactive bladder (OAB); quality of life (QoL)
Hrčak ID:
262630
URI
Publication date:
18.11.2020.
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