Psychiatric morbidity in bladder exstrophy-epispadias complex: A systematic review with a population-based...

Area of Science:

• Urology
• Psychiatry
• Public Health

Background:

• Bladder exstrophy and epispadias complex (BEEC) is a rare congenital anomaly with profound medical and psychosocial impacts.
• Evaluating psychiatric morbidity in BEEC patients is essential due to its significant implications.

Purpose of the Study:

• To determine the prevalence and identify risk factors for psychiatric morbidity in individuals with bladder exstrophy and epispadias complex.
• To assess the mental health burden associated with BEEC across different age groups.

Main Methods:

• A systematic literature review adhering to PRISMA guidelines was conducted, including studies on psychiatric disorders and quality of life in BEEC patients.
• Article quality was assessed using the Newcastle-Ottawa Scale, and prevalence data were extracted.
• A retrospective national registry study in Finland identified BEEC patients (born 2001-2006) and compared them to a matched control group for psychiatric diagnoses.

Main Results:

• The systematic review included 30 studies with 1179 participants, revealing an overall psychiatric morbidity prevalence of 31% (95% CI 17%-47%).
• Psychiatric morbidity was highest in adolescents and comparable to the general population in adults.
• In the Finnish cohort, 80% of BEEC patients received a psychiatric diagnosis versus 26% of controls (OR 11.2, p < 0.001), with no significant association found for anomaly severity, surgeries, or maternal factors.

Conclusions:

• Bladder exstrophy and epispadias complex is linked to a substantially increased risk of psychiatric morbidity.
• The findings underscore the necessity of systematic mental health evaluations and integrated support systems for individuals with BEEC.