Increased
risk of major depression in women with
incontinence
Urinary
incontinence and major depression are more
prevalent in women than in men. Both conditions
are associated with social stigma, functional
impairment and decreased quality of
life. In addition depression is linked to
increased disability, lost productivity, and
excess mortality. Co-occurence may lead to
enhanced social avoidance due to the
embarrassment and shame caused by incontinence.
To better understand the relationship between
depression and urinary incontinence, a study
evaluated the prevalence of major depression in
women with urinary incontinence.
A survey questionnaire was mailed to 6000
randomly selected women aged 30-90 years, who
were enrolled with a large health maintenance
organization, of whom 3536 (64%) responded. The
prevalence of urinary incontinence (any leakage
that occurs at least monthly) was 42% (n = 1458)
and increased nearly linearly with age, from 28%
in women in their 30s to 55% in their 90s. The
prevalence of major depression was 3.7% (n =
129) of the general population, 6.1% in women
with incontinence and 2.2% in women without this
condition. Prevalence of major depression
differed according to incontinence severity
(2.1% in women with mild incontinence, 5.7% in
those with moderate incontinence and 8.3% in
those with severe incontinence), and to
incontinence type (4.7% for stress incontinence
and 6.6% for urge/mixed incontinence). After
controlling for age and medical comorbidity, it
was found that obesity (odds ratio (OR) = 2.3),
current smoking (OR = 2.7) and lower educational
attainment (OR = 2.0) were also factors
associated with increased risk of major
depression in women with urinary incontinence.
Decrease in quality of life and functional
status were greater in women with comorbid
incontinence and major depression compared with
those with incontinence alone.
Improved recognition of urinary incontinence and
major depression especially in association
should lead to more widespread treatment of
these distressing conditions, thus reducing the
symptom burden, and improving the quality of
life of many women. Melville
JL, Delaney K, Newton K, Katon W. Incontinence
severity and major depression in incontinent
women. Obstet Gynecol 2005,
106:585-592.