Population-based cohort study investigating the risk of depression and other psychiatric disorders for patients with overactive bladder (OAB) syndrome is unavailable. This study investigated the subsequent risk of psychiatric disorders among patients with OAB in an Asian population. Using data from the National Health Insurance Research Database of Taiwan, we established a cohort with 811 patients in an exposed group with OAB between January 1, 2000 and December 31, 2000, and a non-exposed group, without OAB, of 2433 patients without OAB matched by age and year of diagnosis. The occurrence of psychiatric disorders and Cox regression model measured adjusted HRs (aHR) were monitored until the end of 2013. The overall incidence of psychiatric disorders was 41.7% higher in the exposed group with OAB than in the non-exposed group without OAB (14.2% vs 10.1%, p<0.001), with an aHR of 1.34 (95% CI 1.12 to 1.80, p<0.001) for the OAB cohort. OAB was associated with the increased risk of dementia, anxiety, depressive, sleep, and psychotic disorders, with aHRs as 1.53 (p=0.040), 1.61 (p<0.001), 2.10 (p<0.001), 1.43 (p<0.001), and 2.49 (p=0.002), respectively. The risk of psychiatric disorders, including depression and anxiety, is significantly higher in patients with OAB than in those without OAB. Evaluation of psychiatric status in patients with OAB is strongly recommended.
AbramsP, WeinAJ. The overactive bladder and incontinence: definitions and a plea for discussion. Neurourol Urodyn1999;18:413–6.doi:10.1002/(SICI)1520-6777(1999)18:4<413::AID-NAU14>3.0.CO;2-6
2.
AbramsP, CardozoL, FallM, . The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology2003;61:37–49.doi:10.1016/S0090-4295(02)02243-4
3.
StewartWF, Van RooyenJB, CundiffGW, . Prevalence and burden of overactive bladder in the United States. World J Urol2003;20:327–36.doi:10.1007/s00345-002-0301-4
4.
YuHJ, LiuCY, LeeKL, . Overactive bladder syndrome among community-dwelling adults in Taiwan: prevalence, correlates, perception, and treatment seeking. Urol Int2006;77:327–33.doi:10.1159/000096337
5.
AbramsP, KelleherCJ, KerrLA, . Overactive bladder significantly affects quality of life. Am J Manag Care2000;6:S580–90.
6.
TubaroA. Defining overactive bladder: epidemiology and burden of disease. Urology2004;64:2–6.doi:10.1016/j.urology.2004.10.047
7.
HullfishKL, FennerDE, SorserSA, . Postpartum depression, urge urinary incontinence, and overactive bladder syndrome: is there an association?Int Urogynecol J Pelvic Floor Dysfunct2007;18:1121–6.doi:10.1007/s00192-007-0313-0
8.
LowensteinL, KentonK, BrubakerL, . The relationship between obstructive sleep apnea, nocturia, and daytime overactive bladder syndrome in women. Am J Obstet Gynecol2008;198:598.e1–e5.doi:10.1016/j.ajog.2008.02.024
9.
BradleyCS, NygaardIE, TornerJC, . Overactive bladder and mental health symptoms in recently deployed female veterans. J Urol2014;191:1327–32.doi:10.1016/j.juro.2013.11.100
10.
Ho ChanWS. Taiwan's healthcare report 2010. Epma J2010;1:563–85.doi:10.1007/s13167-010-0056-8
11.
ChengCL, KaoYH, LinSJ, . Validation of the National health insurance research database with ischemic stroke cases in Taiwan. Pharmacoepidemiol Drug Saf2011;20:236–42.doi:10.1002/pds.2087
12.
LiangJA, SunLM, MuoCH, . The analysis of depression and subsequent cancer risk in Taiwan. Cancer Epidemiol Biomarkers Prev2011;20:473–5.doi:10.1158/1055-9965.EPI-10-1280
13.
ChouIC, LinHC, LinCC, . Tourette syndrome and risk of depression: a population-based cohort study in Taiwan. J Dev Behav Pediatr2013;34:181–5.doi:10.1097/DBP.0b013e3182829f2b
14.
Chinese Hospital Association. ICD-9-CM English-Chinese Dictionary. Taipei, Taiwan: Chinese Hospital Association Press, 2000.
WeinA. Symptom-based diagnosis of overactive bladder: an overview. Can Urol Assoc J2011;5:S135–6.doi:10.5489/cuaj.11183
17.
TzengNS, ChungCH, LinFH, . Anti-herpetic medications and reduced risk of dementia in patients with herpes simplex virus infections-a nationwide, population-based cohort study in Taiwan. Neurotherapeutics2018;15:417–29.doi:10.1007/s13311-018-0611-x
18.
TzengNS, ChungCH, LinFH, . Risk of dementia in adults with ADHD: a nationwide, population-based cohort Study in Taiwan. J Atten Disord2017:108705471771405.doi:10.1177/1087054717714057
19.
TzengNS, ChungCH, LiuFC, . Fibromyalgia and risk of dementia-a nationwide, population-based, cohort study. Am J Med Sci2018;355:153–61.doi:10.1016/j.amjms.2017.09.002
20.
ChengCL, LiJR, LinCH, . Positive association of female overactive bladder symptoms and estrogen deprivation: a nationwide population-based cohort study in Taiwan. Medicine2016;95:e4107.doi:10.1097/MD.0000000000004107
21.
KaoLT, HuangCY, LinHC, . No increased risk of fracture in patients receiving antimuscarinics for overactive bladder syndrome: a retrospective cohort study. J Clin Pharmacol2018;58:727–32.doi:10.1002/jcph.1067
22.
ChungSD, WengSS, HuangCY, . Antimuscarinic use in females with overactive bladder syndrome increases the risk of depressive disorder: a 3-year follow-up study. J Clin Pharmacol2017;57:1064–70.doi:10.1002/jcph.890
23.
WuMP, HsuYW, WengSF, . Healthcare-seeking prevalence of lower urinary tract symptoms among national health insurance enrollees in Taiwan, 2000-2009. Urology2013;81:61–5.doi:10.1016/j.urology.2012.08.033
24.
LinFY, YangYC, LinCL, . Increased risk of overactive bladder in patients with idiopathic Parkinson's disease: Insight from a nationwide population-based cohort study. PLoS One2018;13:e0193783.doi:10.1371/journal.pone.0193783
25.
ChenHM, LinCC, KangCS, . Bladder pain syndrome/interstitial cystitis increase the risk of coronary heart disease. Neurourol Urodyn2014;33:511–5.doi:10.1002/nau.22444
26.
WuMP, WengSF, HsuYW, . Medical attendance for lower urinary tract symptoms is associated with subsequent increased risk of outpatient visits and hospitalizations based on a nationwide population-based database. PLoS One2013;8:e57825.doi:10.1371/journal.pone.0057825
27.
CharlsonME, PompeiP, AlesKL, . A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis1987;40:373–83.doi:10.1016/0021-9681(87)90171-8
28.
CharlsonME, CharlsonRE, PetersonJC, . The Charlson comorbidity index is adapted to predict costs of chronic disease in primary care patients. J Clin Epidemiol2008;61:1234–40.doi:10.1016/j.jclinepi.2008.01.006
29.
ChangCY, ChenWL, LiouYF, . Increased risk of major depression in the three years following a femoral neck fracture–a national population-based follow-up study. PLoS One2014;9:e89867.doi:10.1371/journal.pone.0089867
30.
YooS, OhS, KimHS, . Impact of serum 25-OH vitamin D level on lower urinary tract symptoms in men: a step towards reducing overactive bladder. BJU Int2018.doi:10.1111/bju.14387
31.
AhnKS, HongHP, KweonHJ, . Correlation between overactive bladder syndrome and obsessive compulsive disorder in women. Korean J Fam Med2016;37:25–30.doi:10.4082/kjfm.2016.37.1.25
32.
FeldeG, EbbesenMH, HunskaarS. Anxiety and depression associated with urinary incontinence. A 10-year follow-up study from the Norwegian HUNT study (EPINCONT). Neurourol Urodyn2017;36:322–8.doi:10.1002/nau.22921
33.
MishraGD, BarkerMS, Herber-GastGC, . Depression and the incidence of urinary incontinence symptoms among young women: Results from a prospective cohort study. Maturitas2015;81:456–61.doi:10.1016/j.maturitas.2015.05.006
34.
ChaoPC, ChienWC, ChungCH, . Cognitive enhancers associated with decreased risk of injury in patients with dementia: a nationwide cohort study in Taiwan. J Investig Med2018;66:684–92.doi:10.1136/jim-2017-000595
35.
WennbergAL, MolanderU, FallM, . Lower urinary tract symptoms: lack of change in prevalence and help-seeking behaviour in two population-based surveys of women in 1991 and 2007. BJU Int2009;104:954–9.doi:10.1111/j.1464-410X.2009.08534.x
36.
ReynoldsWS, DmochowskiR, WeinA, . Does central sensitization help explain idiopathic overactive bladder?Nat Rev Urol2016;13:481–91.doi:10.1038/nrurol.2016.95
37.
AnderssonKE. Mechanisms of Disease: central nervous system involvement in overactive bladder syndrome. Nat Clin Pract Urol2004;1:103–8.doi:10.1038/ncpuro0021
38.
KlausnerAP, SteersWD. Corticotropin releasing factor: a mediator of emotional influences on bladder function. J Urol2004;172:2570–3.doi:10.1097/01.ju.0000144142.26242.f3
39.
BaziT, Hajj-HusseinIA, AwwadJ, . A modulating effect of epigallocatechin gallate (EGCG), a tea catechin, on the bladder of rats exposed to water avoidance stress. Neurourol Urodyn2013;32:287–92.doi:10.1002/nau.22288
40.
MerrillL, MalleyS, VizzardMA. Repeated variate stress in male rats induces increased voiding frequency, somatic sensitivity, and urinary bladder nerve growth factor expression. Am J Physiol Regul Integr Comp Physiol2013;305:R147–56.doi:10.1152/ajpregu.00089.2013
