Bladder dysfunction in schizophrenia

In schizophrenic patients with incontinence our previous urodynamic studies showed detrusor hyperreflexia in some cases. Many schizophrenic patients have brain abnormalities similar to those associated with urge incontinence and detrusor hyperreflexia in neurological patients. We therefore propose bladder dysfunction and incontinence as previously unrecognized neurobiological correlates of schizophrenia. To clarify this concept our first step, the present study, was a patient survey for urinary problems. Incontinence was more prevalent in schizophrenic patients than in a comparison group of mood disorder patients at the same hospitals. Urge incontinence and leakage of any type were related closely to psychiatric diagnosis. These data, like our pilot urodynamic studies, suggest that incontinence represents detrusor hyperreflexia in a significant subset of schizophrenic patients. Prospective urodynamic studies will be needed to test our proposal directly.