Depressive symptoms in patients diagnosed with benign prostatic hyperplasia

Abstract

BackgroundSymptoms of depression are common in patients diagnosed with benign prostatic hyperplasia (BPH) and are usually a reaction to deterioration of health, severity of lower urinary tract symptoms, and erectile dysfunction. The aim of this observational study was to evaluate the prevalence of depressive symptoms in patients diagnosed with BPH and factors affecting their occurrence in a large Polish cohort.Patients and methodsFour thousand thirty-five men (4,035) diagnosed with BPH participated in the survey (age 65 ± 8 years). The occurrence of symptoms of depression was assessed using the Beck depression inventory, severity of lower urinary tract symptoms (LUTS) on the basis of the international prostate symptoms score, and erectile dysfunction using the international index of erectile function (IIEF-5).ResultsDepressive symptoms were found in 22.4 % of patients (mild in 20.8 % and moderate/severe in 1.6 %). Erectile dysfunction was found in 71.9 % of patients. Monotherapy for BPH was prescribed to 50.9 % of patients (mostly ARA—selective α1-selective alpha-adrenolytic—47.5 %), while polytherapy (ARA with a 5-alpha reductase inhibitor—5αRI) to 47.9 %. Logistic regression analysis showed a bidirectional relation between the occurrence of depressive symptoms and erectile dysfunction. The occurrence of both depressive symptoms and erectile dysfunction was related to severity of LUTS, nocturia, the use of 5αRI, comorbidity, and sedentary life style.ConclusionsPrevalence of depressive symptoms in patients diagnosed with BPH is associated with severity of LUTS, erectile dysfunction, nocturia, BPH pharmacotherapy (5αRIs), sedentary life style, and comorbidities including obesity.

Prevalence and factors affecting the level of depression, anxiety, and stress in hospitalized patients with a chronic disease

“…On that scale that ranged from 0 to 21 (higher being worse), benign prostate hypertrophy was associated with higher depression, which is in accordance with a recent study that found a higher than normal prevalence of depression among this group of patients . However, in contrary to expectations, dysthyroidism was also associated with higher depression.…”

Risk of Incident Antidepressant‐Treated Depression Associated with Use of 5α‐Reductase Inhibitors Compared with Use of α‐Blockers in Men with Benign Prostatic Hyperplasia: A Population‐Based Study Using the Clinical Practice Research Datalink

“…However, after adjustment for the presence of BPH, the risk of depression was not significantly different for men with treated BPH compared with unexposed men. Results of a cross‐sectional study of 4035 men with BPH in Poland indicated that current use of 5‐ARIs was associated with a 1.52‐fold higher prevalence of depression symptoms; however, the results of this study also suggest that increased severity of BPH symptoms and longer duration of BPH treatment were associated with a higher prevalence of depression symptoms . The results of these prior studies, in which the increased risks of depression diminished and were no longer significant after adjusting for BPH, suggest that confounding by indication may explain the observed increased risk of depression in users of 5‐ARIs.…”

“…Results of another study of 16,130 men diagnosed with BPH reported that the risk of depressive disorder was 1.87 times higher (95% confidence interval [CI] 1.63–2.16) than the risk of depression in a matched cohort of 48,390 men without BPH . With respect to BPH treatment, two studies evaluating men with BPH reported increased risks of depression in men with BPH treated with 5‐ARIs compared with men without BPH . However, because the comparators in these studies were men without BPH, it is possible that the observed increased risks of depression may have been confounded by the underlying disease.…”

“…13 With respect to BPH treatment, two studies evaluating men with BPH reported increased risks of depression in men with BPH treated with 5-ARIs compared with men without BPH. 12,14 However, because the comparators in these studies were men without BPH, it is possible that the observed increased risks of depression may have been confounded by the underlying disease. Thus we conducted a cohort study with a nested case-control analysis to evaluate the risk of incident antidepressant-treated depression in men with BPH who were prescribed 5-ARIs compared with men who were prescribed an active comparator, a-blockers (ABs), for the treatment of BPH.…”

Health‐related quality of life in patients undergoing TURP: Translating evidence into urological nursing practice

“…In line with the concept, depression and decreased HRQoL is also found in those having treatments related to BPH. 84 Patients before undergoing TURP experiences more depressed, worried and another psychiatric morbidity due to by the unsolved prostatic symptoms and pain affecting their marital status and HRQoL, unsuccessful medical treatment, urinary dysfunction, and prostate cancer. 83 Moreover, worsening functional impairments and physical symptoms concerned with BPH trigger depression and anxiety.…”