Anxiety and depression in women with urinary incontinence using E-health

Previous studies have found high prevalence rates of anxiety and depression in women with urinary incontinence (UI). This study investigates the prevalence in women who had turned to eHealth for treatment of UI and identifies possible factors associated with depression.

We analyzed data from two randomized controlled trials evaluating eHealth treatment for UI, including 373 women with stress UI (SUI), urgency UI (UUI), or mixed UI (MUI). We used the Hospital Anxiety and Depression Scale (HADS) and defined a score of ≥8 as depression or anxiety. The ICIQ-UI-SF questionnaire was used to score incontinence severity. Logistic regression was used to determine factors associated with depression and anxiety.

Women with UUI or MUI were older than women with SUI, mean age 58.3 vs 48.6 years (p = <0.001). Four out of five participating women had a university education. The prevalence of anxiety and depression in women with SUI was 12.4% and 3.2% respectively. In women with MUI/UUI, 13.8% had anxiety and 10.6% had depression. In multivariate analyses, the odds ratio of having depression was 4.2 (95% CI = 1.4-12.3) for women with MUI/UUI compared with SUI when controlling for other risk factors.

The odds of depression in women with MUI/UUI were increased compared with SUI. The prevalence of anxiety and depression was considerably lower than reported in large cross-sectional surveys. Socioeconomic differences may partly explain this finding, as the use of eHealth still is more common among highly educated women.