Continence Problems and Mental Health in Adolescents from a UK Cohort.
Continence Problems and Mental Health in Adolescents from a UK Cohort.
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英国队列青少年的失禁问题和心理健康。
DOI：
10.1016/j.eururo.2023.05.013
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发表时间：
2023
期刊：
影响因子：
23.4
通讯作者：
Gordon K
中科院分区：
文献类型：
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作者：
Gordon K
背景有失禁问题的青少年对其心理健康面临着独特的威胁，但长期的心理健康后遗症尚不清楚。目的研究失禁/下尿路症状 (LUTS) 与年轻人心理健康问题之间的前瞻性关系。设计、设置和参与者对基于人群的样本中的年轻人（n = 7332：3639 名男性和 3693 名女性）进行了前瞻性队列研究。结果测量和统计分析我们估计了使用针对性别、社会经济地位、发育水平、智商、压力生活事件、产妇精神病理学、体重指数和情绪/行为问题进行调整的多变量回归模型，研究失禁/LUTS与心理健康结果之间的关联。结果和局限性日间排尿和排尿推迟显示与心理健康问题的关联最多。所有失禁亚型/LUTS 均与广泛性焦虑症的几率增加（例如，白天润湿的几率比 = 3.01，95% 置信区间 [1.78, 5.09]，p< 0.001）和/或更高的焦虑评分相关。还有证据表明与常见精神障碍（例如，排尿推迟：1.88 [1.46, 2.41]，p< 0.001）、抑郁（例如，尿急：1.94 [1.19，3.14]，p = 0.008）、抑郁症状（例如，白天尿床：1.70 [1.13， 2.56]，p= 0.01）、自残想法（例如，排尿推迟：1.52 [1.16，1.99]，p= 0.003）和饮食失调（例如，夜尿 1.72 [1.27，2.34]，p= 0.001）。我们无法将我们的结果推广到少数族裔群体、不太富裕的人群和非英国样本。 结论 患有失禁/下尿路症状的年轻人出现心理健康问题的风险增加。需要进一步的研究来确定因果关系的方向。患者总结我们研究了来自大型人群的年轻人的失禁问题与心理健康结果之间的关联。 14岁时有失禁问题的年轻人在18岁时更有可能出现一系列心理健康问题，包括常见的精神障碍、抑郁、焦虑、自残想法和饮食失调。儿科失禁诊所应满足青少年的心理健康需求，并为儿童和青少年心理健康服务提供明确有效的护理途径。
BackgroundAdolescents with continence problems experience unique threats to their psychological well-being, but long-term mental health sequelae are unknown.ObjectiveTo examine prospective relationships between incontinence/lower urinary tract symptoms (LUTS) and mental health problems in young people.Design, setting, and participantsA prospective cohort study of young people (n= 7332: 3639 males and 3693 females) from a population-based sample was conducted.Outcome measurements and statistical analysisWe estimated the association between incontinence/LUTS and mental health outcomes using multivariable regression models adjusted for sex, socioeconomic position, developmental level, intelligence quotient, stressful life events, maternal psychopathology, body mass index, and emotional/behavioural problems.Results and limitationsDaytime wetting and voiding postponement showed the greatest number of associations with mental health problems. All incontinence subtypes/LUTS were associated with increased odds of generalised anxiety disorder (eg, odds ratio for daytime wetting = 3.01, 95% confidence interval [1.78, 5.09],p< 0.001) and/or higher anxiety scores. There was also evidence of associations with common mental disorder (eg, voiding postponement: 1.88 [1.46, 2.41],p< 0.001), depression (eg, urgency: 1.94 [1.19, 3.14],p= 0.008), depressive symptoms (eg, daytime wetting: 1.70 [1.13, 2.56],p= 0.01), self-harm thoughts (eg, voiding postponement: 1.52 [1.16, 1.99],p= 0.003), and disordered eating (eg, nocturia 1.72 [1.27, 2.34],p= 0.001). We are unable to generalise our results to minority ethnic groups, less affluent populations, and non-UK samples.ConclusionsYoung people with incontinence/LUTS are at an increased risk of mental health problems. Further research is needed to establish the direction of causality.Patient summaryWe looked at the association between continence problems and mental health outcomes in young people from a large population-based cohort. Young people with continence problems at the age of 14 yr were more likely to suffer from a range of mental health problems at the age of 18 yr, including common mental disorder, depression, anxiety, self-harm thoughts, and disordered eating. Paediatric continence clinics should address the mental health needs of young people and provide clear and effective care pathways to child and adolescent mental health services.