Is Major Depression a Risk for Bladder, Bowel, and Sexual Dysfunction?

Although major depression may accompany bladder, bowel and sexual (pelvic organs) dysfunction, no prospective, controlled surveys have been available. The aim of the present study was to study the risk of pelvic organ dysfunction in major depression.

Two hundred and twenty-four depression patients in the psychiatry clinic (97 men, 127 women; average age 42 years; 128 drug-naÏve, 96 medicated) and 391 age-matched local individuals who were undergoing an annual health survey underwent a questionnaire devised for neurologic and psychiatric cohorts.

Compared with control, in the drug-naÏve group the frequency of dysfunction was significantly higher for urinary urgency (20.9% of the women, 25.9% of the men, P < 0.01), urinary incontinence (9.1%, women), retardation in initiating urination (13.1%, men); constipation (23.8%, 14.8%), diarrhea (20.3%, 21.8%); decrease in libido (42%, men), sexual intercourse (70.7%, 78.7%) orgasm (63.6%, 65.0%), erection (92.7% of the men); and quality of life indices. No difference was found in the frequency of all three items between the drug-naÏve group and the medicated group.

The results of the present study suggest that major depression is a risk for all bladder, bowel and sexual dysfunction, and it significantly worsens quality of life in patients. This finding presumably reflects that pelvic organ function is under emotional control. Amelioration of bladder, bowel, and sexual dysfunction is therefore an important target to treat patients with major depression.