Men With Severe Lower Urinary Tract Symptoms Are at Increased Risk of Depression.
Men With Severe Lower Urinary Tract Symptoms Are at Increased Risk of Depression.
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DOI：
10.5213/inj.2015.19.4.286
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发表时间：
2015-12
影响因子：
2.3
通讯作者：
Kim KS
中科院分区：
文献类型：
--
作者：
Jeong WS;Choi HY;Nam JW;Kim SA;Choi BY;Moon HS;Kim KS
下尿路症状（LUTS）包括一组常见的，困扰中年和老年男性的症状。最近的研究表明，抑郁症状可能会影响良性前列腺增生（BPH）的症状。我们进行了一项以社区为基础的横断面研究，以评估LUTS和抑郁症之间的相关性。该调查于2009年8月、2010年8月、2011年8月和2012年8月在农村社区进行。两个有效的问卷调查被用来检查LUTS和抑郁症状。其中包括国际前列腺症状评分/生活质量（IPSS/QoL）和韩国版流行病学中心抑郁量表（CES-D-K）。如果患者的CES-D-K评分>16分，则将其归类为抑郁症状组。共有711名男性被纳入本研究。35例（4.92%）被发现有抑郁症状。抑郁症状与LUTS严重程度呈正相关（P<0.001）。与轻度LUTS组相比，中度LUTS组抑郁的比值比（OR）为2.868（95%置信区间[CI]，1.293-6.362;趋势P <0.001），重度LUTS组为4.133（95% CI，1.510-11.313;趋势P <0.001）。在考虑年龄、教育水平、吸烟和运动等多个变量的模型中，中度LUTS组的OR为2.534（1.125-5.708，95%CI，趋势P =0.005），而重度LUTS组的OR为3.910（95%CI，5.708-11.154;趋势P =0.005）。此外，抑郁与排尿症状有关。患有严重LUTS的男性患抑郁症的风险高于泌尿系统症状不严重的男性。排尿症状的严重程度相当于抑郁症。由于对抑郁症状和生活质量的影响，重度下尿路症状患者需要更积极的泌尿外科诊断和治疗。
Lower urinary tract symptoms (LUTS) comprise a set of common, bothersome symptoms in middle-aged and elderly men. Recent research suggests that depressive symptoms may influence the symptoms of benign prostatic hyperplasia (BPH). We performed a community-based cross-sectional study to evaluate the correlation between LUTS and depression. The survey was conducted in a rural community during four periods in August 2009, 2010, 2011, and 2012. Two validated questionnaires were used to examine LUTS and depressive symptoms. These included the International Prostate Symptom Score/quality of life (IPSS/QoL) and the Korean version of the Center for Epidemiological Studies-Depression scale (CES-D-K). Patients were categorized in the depressive symptom group if their CES-D-K score was >16 points. A total of 711 men were included in this study. Thirty-five participants (4.92%) were found to have depressive symptoms. There was a positive correlation between depressive symptoms and LUTS severity (P<0.001). As compared to the mild LUTS group, the odds ratio (OR) of depression was 2.868 (95% confidence interval [CI], 1.293–6.362; P for trend<0.001) in the moderate LUTS group, and 4.133 (95% CI, 1.510–11.313; P for trend<0.001) in the severe LUTS group. In a model considering multiple variables such as age, education level, smoking, and exercise, the OR in the moderate LUTS group was 2.534 (1.125–5.708, 95% CI, P for trend=0.005), while that in the severe LUTS group was 3.910 (95% CI, 5.708–11.154; P for trend=0.005). In addition, depression was related to voiding symptoms. Men with severe LUTS are at higher risk of depression than those with less severe urinary symptoms. The severity of voiding symptoms worsens depression. More aggressive urological diagnosis and treatment is needed in patients with severe LUTS, due to the impact on depressive symptoms and QoL.