TY - JOUR
T1 - Systematic review and meta-analysis identify significant relationships between clinical anxiety and lower urinary tract symptoms
AU - Mahjani, Behrang
AU - Koskela, Lotta Renström
AU - Batuure, Anita
AU - Gustavsson Mahjani, Christina
AU - Janecka, Magdalena
AU - Hultman, Christina M.
AU - Reichenberg, Abraham
AU - Buxbaum, Joseph D.
AU - Akre, Olof
AU - Grice, Dorothy E.
N1 - Publisher Copyright:
© 2021 The Authors. Brain and Behavior published by Wiley Periodicals LLC
PY - 2021/9
Y1 - 2021/9
N2 - Background: Lower urinary tract symptoms (LUTS), such as voiding symptoms, overactive bladder, and interstitial cystitis, and anxiety disorders are often comorbid conditions in patients. However, the existing evidence regarding the rates and nature of the co-occurrence of these conditions has not been systematically evaluated. The aim of this study was to examine these relationships. Methods: We conducted a systematic review and meta-analysis to examine the relationship between LUTS and anxiety. We searched for articles published from January 1990 to July 2019 in PubMed, CENTRAL, PsycINFO, and Google Scholar. Outcomes were anxiety-related disorders and symptoms (clinically significant anxiety) and LUTS. We performed random-effects meta-analyses, inspected funnel plots, and applied the Egger's test to evaluate publication bias. We followed PRISMA guidelines and recorded our protocol on PROSPERO (ID = CRD42019118607). Results: We identified 814 articles, of which 94 fulfilled inclusion criteria, and 23 had sufficient data for meta-analysis. The odds ratio (OR) for clinically significant anxiety among individuals with LUTS was 2.87 (95% CI: 2.38,3.46, p <.001). The OR for LUTS among individuals with clinically significant anxiety was 2.87 (95% CI: 1.07,7.74, p <.001), although very few studies examined this relationship. A large value of I2 index suggests high heterogeneity between studies. Conclusion: The results demonstrate a significant association between clinically significant anxiety and LUTS in both females and males. There were limited studies on younger individuals and on individuals ascertained for clinically significant anxiety, which should motivate further study in these areas. Understanding the co-occurrence of these conditions will lead to better prevention and interventions to ameliorate the progression of the symptoms and improve the quality of life. A thorough assessment of anxiety may provide more optimal care for LUTS patients.
AB - Background: Lower urinary tract symptoms (LUTS), such as voiding symptoms, overactive bladder, and interstitial cystitis, and anxiety disorders are often comorbid conditions in patients. However, the existing evidence regarding the rates and nature of the co-occurrence of these conditions has not been systematically evaluated. The aim of this study was to examine these relationships. Methods: We conducted a systematic review and meta-analysis to examine the relationship between LUTS and anxiety. We searched for articles published from January 1990 to July 2019 in PubMed, CENTRAL, PsycINFO, and Google Scholar. Outcomes were anxiety-related disorders and symptoms (clinically significant anxiety) and LUTS. We performed random-effects meta-analyses, inspected funnel plots, and applied the Egger's test to evaluate publication bias. We followed PRISMA guidelines and recorded our protocol on PROSPERO (ID = CRD42019118607). Results: We identified 814 articles, of which 94 fulfilled inclusion criteria, and 23 had sufficient data for meta-analysis. The odds ratio (OR) for clinically significant anxiety among individuals with LUTS was 2.87 (95% CI: 2.38,3.46, p <.001). The OR for LUTS among individuals with clinically significant anxiety was 2.87 (95% CI: 1.07,7.74, p <.001), although very few studies examined this relationship. A large value of I2 index suggests high heterogeneity between studies. Conclusion: The results demonstrate a significant association between clinically significant anxiety and LUTS in both females and males. There were limited studies on younger individuals and on individuals ascertained for clinically significant anxiety, which should motivate further study in these areas. Understanding the co-occurrence of these conditions will lead to better prevention and interventions to ameliorate the progression of the symptoms and improve the quality of life. A thorough assessment of anxiety may provide more optimal care for LUTS patients.
KW - anxiety disorders
KW - interstitial cystitis
KW - lower urinary tract symptoms
KW - obsessive-compulsive disorder
KW - overactive bladder
UR - http://www.scopus.com/inward/record.url?scp=85112585969&partnerID=8YFLogxK
U2 - 10.1002/brb3.2268
DO - 10.1002/brb3.2268
M3 - Article
C2 - 34402598
AN - SCOPUS:85112585969
SN - 2157-9032
VL - 11
JO - Brain and Behavior
JF - Brain and Behavior
IS - 9
M1 - e2268
ER -