Neurotic personality and lower urinary tract symptoms in day hospital patients diagnosed at pretreatment between 2004 and 2014. / Osobowosc nerwicowa a objawy z dolnego odcinka ukladu moczowego u pacjentów kwalifikowanych do leczenia psychoterapia na oddziale dziennym w latach 2004­2014.

OBJECTIVES: Evaluation of the association between the occurrence of lower urinary tract symptoms in patients qualified for psychotherapy and the severity and profile of their neurotic personality disorders. MATERIAL AND METHODS: Retrospective analysis of questionnaires included in the medical records of 2,450 patients qualified for psychotherapy in 2004-2014 in terms of correlations between the symptoms of pollakiuria and unconscious urinary incontinence, and the global severity of neurotic symptoms (OWK), global severity of neurotic personality disorders (XKON) and abnormal values of 24 scales of the KON-2006 questionnaire. Correlations in the form of OR coefficients with 95% confidence intervals were estimated using logistic regression analyzes. RESULTS: Lower urinary tract symptoms are associated with a significantly greater severity of neuroticism, both described by the global severity of symptoms (OWK) as well as by the global neurotic personality disorder index (XKON) and abnormal values of the KON-2006 questionnaire scales. The occurrence of both symptoms was associated with the following scales: 'Negative self-esteem' and 'Envy', the occurrence of pollakiuria - with the scales 'Feeling of being dependent on others', 'Demobilization', 'Conviction of life helplessness' and 'Feeling of lack of influence', the occurrence of unconscious urinary incontinence - with the scales 'Feeling of being alienated' and 'Exaltation' for both genders, and only in men 'Risk avoidance' (low 'Risk tendencies'), 'Conviction of life helplessness', 'Difficulties in interpersonal relations'. Extreme severity of pollakiuria was more strongly associated with many of the mentioned scales, and also slightly differently with other scales, e.g., in men - with the 'Sense of overload' and 'Imagination, fantasizing'. CONCLUSIONS: Neurotic personality traits described by abnormal values of the KON-2006 questionnaire scales are associated with the presence (and also to some extent with the severity) of psychogenic lower urinary tract symptoms. Connections may be bi-directional - in some cases experiencing and self-description of personality traits may be secondary to suffering associated with pollakiuria and incontinence.

Nocturia has no impact on depression severity in patients suffering from depression but correlates with sleep quality. / Nykturia nie wplywa na nasilenie depresji u cierpiacych na nia pacjentów, ale koreluje z zaburzeniami snu.

OBJECTIVES: In general population, the relationship between nocturia, depressive symptoms and sleep disturbance has been widely investigated. However, there is a paucity of data analyzing the significance of nocturia for depression severity and potential influence of nocturia on sleeping problems in depressed patients. To address this vacuum, we analyzed the impact of nocturia on depression severity and sleep quality in patients suffering from depression. METHODS: We conducted a cross-sectional study of depressed patients treated in outpatient and inpatient Department of Adult Psychiatry, Jagiellonian University, Krakow. All patients met the DSM-5 and ICD-10 criteria for depression. Nocturia was assessed with the International Prostate Symptom Score (IPSS), severity of depression with the 17-item Hamilton Rating Scale for Depression (HRDS), and sleep quality with the Holland Sleep Disorders Questionnaire (HSDQ). Statistical analysis was carried out using an ANOVA test (post-hoc Tukey test). RESULTS: Totally, 98 patients were included in our analysis. Nocturia was reported by 68 individuals. Majority of our patients (35) suffered from mild depression. The mean HSDQ score was 78.8 (range 32-146). Our analysis rejected the impact of nocturia on depression severity (p = 0.625) but revealed statistically significant correlation between nocturia and sleep quality (p = 0.037). A post-hoc test investigating the relationship between severity of nocturia and sleeping problems has demonstrated that higher number of night-time episodes of urination (at least 3 episodes) leads to significantly higher scores in the HSDQ. CONCLUSIONS: Our analysis showed no impact of nocturia on illness severity in patients suffering from depression. However, we demonstrated correlation between nocturia and sleep quality in depressed individuals. Further studies with a larger number of patients are needed to validate the obtained results.

Perception of Lower Urinary Tract Symptoms by psychiatrists in mentally affected patients. / Percepcja objawów z dolnego odcinka dróg moczowych (Lower Urinary Tract Symptoms ­ LUTS) przez lekarzy psychiatrów.

OBJECTIVES: Lower urinary tract symptoms (LUTS) are highly prevalent and costly condition worldwide. Numerous studies have demonstrated their negative impact on health-related quality of life (HRQL), as well as on physical and mental health. The co-existence of LUTS and psychiatric symptoms is common and has been described by psychiatrists, urologists and gynecologists. However, data are lacking regarding the perception of urological symptoms by psychiatrists in their day-to-day clinical practice. METHODS: 31-question survey was designed to learn what is the perception of LUTS among psychiatrists. Survey link was sent by email to all psychiatrists registered to the Polish Association of Psychiatry via the association's email lists. The SurveyMonkey website was used as a platform where responses were collected and stored. RESULTS: 953 physicians completed the questionnaire. Majority of investigated psychiatrists only 'occasionally'ask their patients about voiding dysfunctions. Respondents estimated the frequency of voiding dysfunctions in their patients as 'moderately frequent'with a '10-30%' prevalence. However, discrepancies between different subgroups of psychiatrists have been noted. Furthermore, psychiatrists may not be fully aware of the effects of psychiatric treatment (psychotherapy/pharmacotherapy) on LUTS improvement, as well as possible deteriorations of voiding dysfunctions with psychiatric disorder progression. CONCLUSIONS: This survey showed that the perception of urological symptoms by psychiatrists in their patients may be limited. Therefore, it is necessary to adequately inform and educate psychiatrists in terms of the impact of urological symptoms on patients'management, prognosis and quality of life.

Lower urinary tract symptoms, nocturia and overactive bladder in patients with depression and anxiety. / Objawy z dolnego odcinka dróg moczowych, nokturia oraz nadaktywnosc pecherza moczowego u chorych z lekiem i depresja.

Lower urinary tract symptoms (LUTS) remain highly prevalent worldwide, and are well known to negatively impact patients' quality of life, sleep and psychosocial wellbeing. Conversely, both depression and anxiety have been shown to have a negative effect on perception, development and prolongation of LUTS. This paper provides an overview of an association between the lower urinary tract symptoms, depression and anxiety. It also explores possible common mechanisms underlying the causes of both conditions. There has been a large body of evidence linking LUTS with anxiety and/or depression. Studies have documented not only a significant impact of LUTS on the psychosocial wellbeing, but also showed a strong negative effect of depression and anxiety on perception, development and prolongation of LUTS. High level of psychiatric morbidity has important implications on the appropriate management in patients with LUTS, as well as LUTS may have important implications on development and management of depression and anxiety. Therefore, clinicians should be aware of the bidirectional association between LUTS and anxiety and/or depression, as some patients may require a multidisciplinary approach and a combined treatment. The precise common mechanism underlying LUTS, depression and anxiety remain largely unknown and further research is needed to elucidate the underlying pathophysiological pathways.

Occurrence of selected lower urinary tract symptoms in patientsof a day hospital for neurotic disorders. / Wystepowanie wybranych objawów z dolnego odcinka ukladu moczowego u pacjentów dziennego oddzialu leczenia zaburzen nerwicowych.

OBJECTIVES: To assess the occurrence of selected lower urinary tract symptoms in the population of patients with neurotic and personality disorders. METHODS: This was a retrospective analysis of occurrence, co-existence and severity of two selected lower urinary tract symptoms in 3,929 patients in a day hospital for neurotic disorders. The KO "O" symptom checklist was used to measure the study variables. RESULTS: Although the symptoms associated with micturition are not the most prevalent symptoms of neurotic disorders, neither are they the most typical ones, the prevalence of urinary frequency referring to the last week before psychotherapy evaluated among the patients of a day hospital, was approximately 50%. Involuntary micturition, a symptom with a significant implication on the self-esteem and social functioning was much less common; it was reported by approximately 5% relatively healthy and young group of patients. Major bother from urinary frequency was reported by 9-14% of patients, whereas from involuntary micturition by only 0.6%-1% of the surveyed patients. CONCLUSIONS: Selected urological symptoms seem to be prevalent among the patients with neurotic and personality disorders, and are independent of the specific diagnosis or patients' gender. Their co-existence with other symptoms of neurotic disorders reported by the patients indicates their strongest relationship with the somatoform, dissociative, sexual and agoraphobic disorders.

Associations of selected lower urinary tract symptoms with biographical context in patients of a day hospital for neurotic disorders. / Zwiazki wybranych objawów z dolnego odcinka ukladu moczowego z kontekstem biografii pacjentów dziennego oddzialu leczenia zaburzen nerwicowych.

OBJECTIVES: To assess the correlation of subjectively estimated biographical context and lower urinary tract symptoms reported by patients with neurotic and personality disorders. METHODS: This was a retrospective analysis of the biographical context of co-existence of urinary frequency and urinary incontinence reported by 3,929 patients in a day hospital for treatment of neurotic disorders. The symptom checklists KO "0" were completed by patients prior to any treatment. RESULTS: Urinary frequency reported by patients in a day hospital for treatment of neurotic disorders was associated with the difficulties from their childhood and adolescence (i.e. with perception of inferiority with regard to one's family and among siblings, parents' low education level), as well as the disparities in terms of sexual education and troubled relationships. CONCLUSIONS: In the studied group of patients with neurotic and personality disorders, selected lower urinary tract symptoms were associated with adverse life circumstances from childhood and adolescence (which can show the tendency towards regression and protracted character to experience of family's dysfunction due to feeling of being neglected or abandoned), as well as, to a larger or a smaller degree, their consequences - dysfunctions in adulthood, relationship/marriage, functioning at work and dealing with finances. These associations indicated the probable significance of experiencing these aspects of life in patients, not only in day hospitals or psychiatric hospitals which reported "pseudo-urological complaints", but also in at least part of urological patients - going to hospitals due to neurotic disorders, particularly those occurring in a somatic form.