Lower Urinary Tract Symptoms Are Associated with Depressive Symptoms in White, Black and Hispanic Men in the United States

Purpose: The relationship between lower urinary tract symptoms and depressive symptoms was assessed using data from the Male Attitudes Regarding Sexual Health study.

Materials And Methods: Lower urinary tract symptoms, depressive symptoms and erectile dysfunction were assessed using International Prostate Symptom Score, Center for Epidemiologic Studies Depression Scale and a validated question from the Massachusetts Male Aging Study. Sociodemographic, clinical and other data were also collected. Odds ratios and 95% CIs were determined using weighted multivariate logistic regression stratified by race/ethnicity and age.

Results: Of 3,291 randomly selected men 2,173 completed the interview. Overall odds of lower urinary tract symptoms were increased in men who reported depressive symptoms (OR 2.68, 95% CI 1.60-4.47, p <0.01), erectile dysfunction (OR 1.73, 95% CI 1.11-2.71, p <0.05) and unhappiness/dissatisfaction on the International Prostate Symptom Score quality of life item (OR 10.72, 95% CI 5.56-20.69, p <0.01), and those 60 to 69 years old (OR 1.99, 95% CI 1.14-3.46, p <0.05) and 70 years or older (OR 1.91, 95% CI 1.06-3.43, p <0.05). Increased odds of lower urinary tract symptoms were associated with depressive symptoms for white (OR 2.60, 95% CI 1.39-4.85, p <0.01) and Hispanic men (OR 4.14, 95% CI 1.15-14.95, p <0.05). Odds of depressive symptoms were increased in men reporting lower urinary tract symptoms (OR 2.64, 95% CI 1.57-4.43, p <0.001), especially Hispanic men 50 to 59 years old (OR 133.17, 95% CI 18.40-963.87, p <0.01) and black men older than 60 years (OR 21.61, 95% CI 3.04-153.55, p <0.01), as well as men 40 to 49 years old expressing unhappiness/dissatisfaction on the International Prostate Symptom Score quality of life item (OR 6.80, 95% CI 1.77-26.16, p <0.01), and Hispanic (OR 10.76, 95% CI 3.88-29.80, p <0.01) and black men reporting erectile dysfunction (OR 4.77, 95% CI 1.15-19.78, p <0.05), but not white men reporting erectile dysfunction (OR 1.05, 95% CI 0.48-2.28, p <0.91).

Conclusions: Lower urinary tract symptoms and depressive symptoms are strongly associated, and exhibit reciprocal relationships. Erectile dysfunction increases the odds of both disorders.