UroToday - Mental health, pain and urinary symptoms are correlated. In an interesting study, Dr. J. Quentin Clemens and colleagues from Chicago recruited patients with chronic prostatitis/chronic pelvic pain syndrome and 111 females with bladder pain syndrome from Northwestern University urology clinics. They recruited 72 male controls and 175 female controls from several sources. Subjects completed self-administered questionnaires that included items about demographics, medical history, medication use and urological symptoms. The Patient Health Questionnaire was used to identify depression and panic disorder, disorders for which it has specificity of almost 99% and sensitivity of over 70%.

In men, 13% of the cases met criteria for depression or panic disorder compared to 4% of controls. Seven percent met major depression criteria and 5% more had depressive symptoms. Corresponding control values for both types of depression were 1%. Of the males, 6% had panic disorder compared to 1% of controls.

In women, 23% of cases had mental health disorders versus 3% in the control group. Five percent had major depression and 11% had depressive symptoms versus corresponding values in controls of 1% and 2% respectively. Panic disorder was noted in 14% of BPS patients versus 1% of controls.

Medications for anxiety, depression, or stress were taken by 37% of patients with BPS, 18% of males with chronic prostatitis, and 13% of female controls and 7% of male controls. Income over $50,000 correlated with a lower incidence of mental health issues.

The authors concluded that chronic pelvic pain patients should be screened for depression and panic disorder, and a multidisciplinary approach to treatment is optimal.

Clemens JQ, Brown SO, Calhoun EA
J Urol. 2008 Oct;180(4):1378-82

UroToday Contributing Editor Philip M. Hanno, MD, MPH

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