Incontinence Associated With Higher Risk of Depression in Women

Incontinence is associated with nearly double the risk of depression for women with the problem than those without, according to a large Canadian study.

Younger women with urinary incontinence were more likely to be depressed than older women with incontinence, the study in the March-April issue of the journal Psychosomatics also found.

The study is based on information gathered by the Canadian Community Health Survey, which contacted people across Canada. Data were used from 69,003 women over age 18 who were not pregnant, said Donna E. Stewart, M.D., chair of Women’s Health at the University of Toronto and lead study author.

The combination of incontinence and depression was found to be associated with many negative effects, including stress, increased visits to a physician and lost days from work, Stewart said.

The prevalence of depression was 15.5 percent in women with urinary incontinence, compared with 9.2 percent in women without urinary incontinence. The prevalence of depression rose to 30 percent for women ages 18 to 44.

The severity of incontinence was not evaluated, Stewart said, and incontinence may also have been underreported because the women were only asked about it in the context of chronic conditions that were diagnosed by a physician.

The presence of depression was more carefully evaluated during the survey with the use of a specialized diagnostic interview.

“There is certainly food for thought here,” said Jean Hay-Smith, Ph.D., of the Wellington School of Medicine and Health Sciences at the University of Otago, Dunedin, New Zealand. As a population study, the Canadian survey was ideal for investigating any association between key variables such as incontinence and depression, said Hay-Smith, who was not associated with the study.

However, just asking women if they have urinary incontinence may not be enough, Hay-Smith said. “Many people with the problem do not use the medical terms for it -  it is more common for women to talk about dribbling, leaking or lack of bladder control.” Many women do not see their doctor about incontinence, she added.

A further study of incontinence and depression based on women who may not have a doctor’s diagnosis of incontinence is underway, Stewart said.

Vigod SM, Stewart DE. Major depression in urinary female incontinence. Psychosomatics 47(2), 2006.