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Title: An investigation of the relationship between anxiety and depression and urge incontinence : development of a psychological model
Author: Perry, Sarah I.
Awarding Body: University of Leicester
Current Institution: University of Leicester
Date of Award: 2003
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Aims: The study investigated the association between anxiety and depression and urge incontinence and the direction of causal pathways between these variables. The objective was to produce a psychological model that described the contribution of emotional factors in the development and maintenance of urge incontinence. Methods: In this prospective longitudinal study, a random sample of women aged 40 years or more, registered with a general practitioner in Leicestershire or Rutland, was mailed a postal questionnaire. The questionnaire included questions on general health, urinary symptoms and the Hospital Anxiety and Depression Scale (HADS). In total, 12, 568 women responded to the baseline postal survey (65.3% response rate) and 9,596 to the first annual follow-up (79.8% response rate). The prevalence and one-year incident rates of these symptoms were compared and contrasted, whilst controlling for confounding variables (e.g. long-term illness, age and other urinary symptoms). Results: A significant proportion of women with urge incontinence reported symptoms of anxiety (56.6%) and depression (37.6%). These symptoms were positively associated with the severity of incontinence and the presence of other urinary symptoms. Anxiety and depression were associated with a number of urinary symptoms and were not exclusive to urge incontinence. Incident cases of anxiety and depression were predicted by the presence of urge incontinence at baseline. Incident cases of urge incontinence were predicted by anxiety at baseline, but not depression. Anxiety, urge incontinence and frequency appeared to interact and exacerbate each other. Conclusion: The findings demonstrated the relevance of emotional factors in the development and maintenance of urge incontinence. Currently, assessment and treatment protocols for urge incontinence concentrate on physical symptoms and toilet behaviours. A more integrated psychological model of urge incontinence is proposed along with how this might be implemented and evaluated in clinical practice.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available