Objective: To investigate the relationship between urinary dysfunction (UD) and anxiety and depression in Parkinson’s Disease (PD).   

Background: Urinary dysfunction is one of the most frequent non-motor symptoms in PD. Neuropsychiatric problems are observed in two third of the patients, most of which have been reported as depression and anxiety. It has been considered that the urological problems appearing in PD may form a basis for the development of anxiety and depression.

Methods: The study included 48 patients with a diagnosis of idiopathic PD. The Hamilton depression and Hamilton anxiety scales were applied to all patients. The urological complaints were recorded individually and the urinary complaints were questioned using the IPSS (the International Prostate Symptom Score) survey. 

Results: Among the participants, 32 were male and 16 were female. The mean age was 69.84 years.  The UD and the anxiety and depression scores were related (p=0.01 and p=0.01, respectively). Urinary complaints had increased the risk of depression and anxiety by 1.06 and 1.28 -fold, respectively. Urgency was found to be related to anxiety and depression scores (p=0.04, p=0.04). Urgency had increased the anxiety and depression scores by 1.05 and 1.07-fold, respectively. Nocturia was found to be related to anxiety (p<0.001).It was not related to depression (p=0.42). Nocturia had increased anxiety scores by 1.19- fold and incontinence had increased the risk of anxiety by 1.24-fold. There was a relationship between incontinence and anxiety (p=0.02), no relation was determined between incontinence and depression (p=0.84). A relationship was determined between IPSS score and depression and anxiety (p=0.03, p=0.005). The IPSS score had increased depression and anxiety risks by 1.1-fold. 

Conclusions: In our study, nocturia and incontinence were related to the development of anxiety in particular, and was not related to the development of depression. Additionally, the total score of IPSS, which investigated the lower urinary system complaints (incomplete emptying, urination, urgency, weak flow, nocturia frequency, straining frequency) was related to both depression and anxiety.  In conclusion, the presence of urinary symptoms alone has increased the incidence of anxiety by a minimum of 1-fold, whereas the increase in the frequency of urinary symptoms has increased the risk of both anxiety and depression in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-urinary-dysfunction-on-depression-and-anxiety-development-in-parkinsons-disease/