Mental health and lower urinary tract symptoms: Results from the NHANES and Mendelian randomization study.

ABSTRACT

BACKGROUND: The clinical observations suggest a correlation between lower urinary tract symptoms (LUTSs) and mental health problems. Nonetheless, establishing a direct causal relationship between them remains challenging. METHODS: We initially conducted a cross-sectional study using 2005-2018 the National Health and Nutrition Examination Survey (NHANES) data. Multivariable-adjusted logistic regression was the primary statistical approach. Additionally, we employed Mendelian randomization (MR) to reducing confounding and reverse causation. Genetic instruments were obtained from publicly available genome-wide association study (GWAS) databases. Inverse Variance Weighted was the primary statistical method. RESULTS: The cross-sectional study involved 29,439 participants. Individuals with mental health problems had a higher risk of urinary incontinence (OR4.38; 95%CI3.32-5.76; P < 0.01) and overactive bladder (OR2.31; 95%CI2.02-2.63; P < 0.01). MR analysis then indicated a potential causal relationship between mental health problems and LUTSs. Depression symptoms was linked with urinary tract infection (UTI) (OR1.005; 95%CI1.003-1.008; PFDR < 0.01). Anxiety symptoms was related to the occurrence of UTI (OR1.024; 95%CI1.011-1.037; PFDR < 0.01) and bladder calcified/ contracted/ overactive (OR1.017; 95%CI1.007-1.027; PFDR < 0.01). The personality trait of neuroticism was related to the occurrence of cystitis (OR1.072; 95%CI1.022-1.125; PFDR = 0.02), extravasation of urine and difficulties with micturition (OR1.001; 95%CI1.001-1.002; PFDR < 0.01), and urinary frequency and incontinence (OR 1.001; 95%CI1.000-1.001; PFDR < 0.01). CONCLUSIONS: Our study provides various evidence for the correlation between mental health and LUTSs, emphasizing the significance of adopting a holistic approach to LUTSs management that incorporates both physical and psychological factors.