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Association Between Depression Subtypes and Interstitial Cystitis/Bladder Pain Syndrome
Kun-Min Chang1,2, Ming-Huei Lee3,4,5, Yung-Fu Chen6,7
1Department of Obstetrics and Gynecology, Feng Yuan Hospital, Ministry of Health and Welfare, Taichung, Taiwan.
Introduction And Hypothesis:
Interstitial cystitis/bladder pain syndrome (IC/BPS) and depression are persistent disorders of uncertain etiology that commonly present together without an established link. However, the mechanism underlying the link between these conditions is unclear. The aim of this study was to investigate the association between depression subtypes and IC/BPS.
Methods:
Using a nationwide database, patients newly diagnosed with depression (2002-2013) were identified and stratified into three subgroups, i.e., recurrent major depression (RD), single-episodic major depression (SD), and persistent depression (PD), by excluding those with prior IC/BPS and IC/BPS diagnosed within 6 months after depression diagnosis. Propensity-score matching based on sex, age, and 12 comorbidities was applied to compare the risk of IC/BPS between depression and non-depression cohorts. Incidence rate and time to IC/BPS onset were also evaluated.
Results:
In the propensity-score matched models, compared with the non-depression cohort, patients with RD and PD exhibited a significantly higher likelihood of developing IC/BPS (RD p = 0.034; PD p < 0.001) and a significantly shorter interval to disease onset (RD p = 0.031; PD p < 0.001). In contrast, the SD cohort exhibited a significantly shorter interval to disease onset (p = 0.030) but non-significantly higher IC/BPS risk (p = 0.532) than the non-depression cohort.
Conclusions:
Persistent and recurrent major depressive disorders were associated with a significantly elevated hazard ratio in developing IC/BPS, indicating increased susceptibility in these patients. Moreover, the time to IC/BPS onset was notably shorter among these patients. These findings highlight the importance of early detection and management of persistent and recurrent depression to potentially reduce the risk of or delay the onset of IC/BPS.
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