Bladder dysfunction in schizophrenia

Bonney, William W.; Gupta, Sanjay; Hunter, David R.; Arndt, Stephan

doi:10.1016/s0920-9964(97)00021-2

Cited by 26 publications

(35 citation statements)

References 9 publications

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“…There are also a number of relatively large studies that showed sexual dysfunction to be more frequent in people with schizophrenia compared to normal controls (133)(134)(135). Increased prevalence of incontinence in people with schizophrenia have also been reported (136,137). Population-based studies on prostate cancer consistently found reduced incidences in people with schizophrenia (57,58,(61)(62)(63)(64)68), please note again that the samples in the Danish studies partly overlapped (61,68).…”

Section: Diseases Of the Nervous System (15 170 Medline Hits)mentioning

confidence: 99%

Physical illness and schizophrenia: a review of the literature

Leucht

Burkard

Henderson³

et al. 2007

Acta Psychiatr Scand

560

358

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Sartorius N. Physical illness and schizophrenia: a review of the literature.Objective: The lifespan of people with schizophrenia is shortened compared to the general population. We reviewed the literature on comorbid physical diseases in schizophrenia to provide a basis for initiatives to fight this unacceptable situation. Method: We searched MEDLINE (1966( -May 2006 combining the MeSH term of schizophrenia with the 23 MeSH terms of general physical disease categories to identify relevant epidemiological studies. Results: A total of 44 202 abstracts were screened. People with schizophrenia have higher prevalences of HIV infection and hepatitis, osteoporosis, altered pain sensitivity, sexual dysfunction, obstetric complications, cardiovascular diseases, overweight, diabetes, dental problems, and polydipsia than the general population. Rheumatoid arthritis and cancer may occur less frequently than in the general population. Eighty-six per cent of the studies came from industrialized countries limiting the generalizability of the findings. Conclusion: The increased frequency of physical diseases in schizophrenia might be on account of factors related to schizophrenia and its treatment, but undoubtedly also results from the unsatisfactory organization of health services, from the attitudes of medical doctors, and the social stigma ascribed to the schizophrenic patients. Summations• According to this review it has been known for decades that incidences physical diseases are frequent in schizophrenia. Nevertheless, some areas such as infectious diseases have not been sufficiently studied.• Psychiatrists are often not trained well enough in the detection and treatment of physical diseases.They must be aware of the frequent medical comorbidities and should play a more active role in their diagnosis, prevention, and treatment.• Other necessary strategies include the education of patients, general practitioners and of doctors working in other medical specialities. The access to medical care of the mentally ill also needs to be improved, among others, by reducing the stigma associated with mental disorders. Considerations• The review covered a broad area of research accordingly, focusing attention to details has not been possible.• Despite the broad search strategy, studies not covered by MEDLINE or not indexed by the MeSH term of schizophrenia could have been missed. • Due to considerable differences in the design and quality of the studies in assorted and diverse areas, quantitative approaches using meta-analysis were not possible, but should be the target of future reviews focusing.

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Section: Diseases Of the Nervous System (15 170 Medline Hits)mentioning

confidence: 99%

Physical illness and schizophrenia: a review of the literature

Leucht

Burkard

Henderson³

et al. 2007

Acta Psychiatr Scand

560

358

View full text Add to dashboard Cite

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“…However, dopaminergic receptors have also been shown to play a role in the central regulation of bladder function in animal studies [Kontani et al, 1990;Yoshimura et al, 1992]. In addition, clinical conditions resulting from an imbalance of dopaminergic function also show a high incidence of micturitional disturbances, for example, Parkinson's disease [Raz, 1976;Berger et al, 1987;Hattori et al, 1992] and schizophrenia [Gupta et al, 1995;Bonney et al, 1997]. In addition to the urinary disturbances associated with clozapine therapy as reviewed above, there are also reports in the clinical literature of patients developing urinary incontinence after being treated with conventional antipsychotics [Ambrosini, 1984].…”

Section: Introductionmentioning

confidence: 99%

Effects of the atypical neuroleptic clozapine on micturition parameters in anesthetized rats

Vera

Nadelhaft

2001

Neurourology and Urodynamics

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Clozapine, an atypical antipsychotic, has resulted in a number of reports of urinary disturbances in the clinical literature. We examined the effects of clozapine on urodynamic parameters in the anesthetized rat and compared the effects to those of the typical antipsychotic haloperidol and the selective D2 and D4 antagonists, raclopride and L-745,870, respectively. Clozapine abolished high-frequency oscillations (HFO) during the expulsion phase, and profoundly altered a number of other parameters (e.g., intercontraction interval and resting pressure). Clozapine did not affect the peak contraction pressure during cystometrograms but displayed peripheral inhibition of bladder contractions elicited by electrical stimulation of the pelvic nerve (possibly mediated via clozapine's anti-muscarinic effects). Haloperidol had less potent effects than clozapine since it reduced the amplitude of HFO to 25% of control and also affected several other parameters but without peripheral bladder inhibition. Raclopride only resulted in a modest decrease (approximately 70% of control) in the HFO and no alteration in other parameters. L-745,870 was effective only at highest dose tested suggesting that it might not be acting selectively at D4 receptors. Therefore, we propose that clozapine primarily interferes with the function of the external urethral sphincter. These effects can only be partly explained through antagonism of D2 receptors. Since both clozapine and haloperidol have interactions with other transmitter systems beside dopamine, we suggest that central antagonism of D2 receptors, coupled to central antagonism of another receptor system and peripheral muscarinic receptor blockade, may account for clozapine's potent effects on micturition.

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“…We defined the presence of LUTS as a score of ≥8, corresponding to moderateto-severe symptoms. For graphical displays, LUTS severity categories were defined using the AUA-SI as follows: no symptoms (score=0), mild (1-7), moderate (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19), severe (≥20). We also examined mean storage and voiding storage subscales of the AUA-SI.…”

Section: Study Design and Data Collectionmentioning

confidence: 99%

“…[8] Lower urinary tract symptoms (LUTS) such as urinary frequency and urgency are bothersome and associated with reduced quality-of-life. [9] Urinary incontinence is a side effect of antipsychotics; [10] as is urge incontinence [11] while a recent study of clozapine (an AAP) suggested that users suffered from an excess of a broader range of LUTS than incontinence alone. [12] There is also evidence that selective serotonin reuptake inhibitor (SSRI) antidepressants could increase the risk of LUTS.…”

Section: Introductionmentioning

confidence: 99%

1726 Are Commonly-Used Psychoactive Medications Associated With Lower Urinary Tract Symptoms?

et al. 2012

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Purpose-Lower urinary tract symptoms (LUTS) such as urinary frequency and urgency are bothersome and associated with reduced quality-of-life. Atypical antipsychotics (AAPs) have been implicated in increasing the risk of urinary incontinence. In a large community-based sample of men and women, we examined the associations of AAP use and selective serotonin reuptake inhibitor (SSRIs) use with LUTS.Methods-Data were collected (2002)(2003)(2004)(2005)) from a generalizable sample of Boston, MA, USA residents aged 30-79 (N=5503). LUTS were assessed using the American Urologic Association Symptom Index (AUA-SI). The prevalence of clinically-significant LUTS was estimated using a cutoff AUA-SI score of 8+ to indicate moderate-to-severe symptoms. Confounder-adjusted odds ratios (ORs) and 95% confidence intervals (CI) were calculated from multivariate logistic regression to estimate the associations for psychoactive drugs used in the previous month (SSRIs, AAPs, both) and LUTS.Results-Among women, AAP users had a higher prevalence of LUTS (46.2%) compared to SSRI users (23.5%) and those with depressive symptoms not using SSRIs or AAPs (26.3%). Corresponding prevalence estimates among men were 32.7%, 29.8%, and 33.3%. In multivariate models, AAP use was significantly associated with LUTS among women when used either with SSRIs (OR=2.72, or without SSRIs (OR=3.05,) but SSRI use without AAP use was not associated with LUTS, compared to non-users without depressive symptoms. No associations were observed among men.Conclusions-In our study, AAPs but not SSRIs were associated with increased prevalence of LUTS among women only. Further prospective research is needed to determine time sequence and cause-and-effect.

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Bladder dysfunction in schizophrenia

Cited by 26 publications

References 9 publications

Physical illness and schizophrenia: a review of the literature

Physical illness and schizophrenia: a review of the literature

Effects of the atypical neuroleptic clozapine on micturition parameters in anesthetized rats

1726 Are Commonly-Used Psychoactive Medications Associated With Lower Urinary Tract Symptoms?

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