AUA 2013: Men with LUTS more likely to have suicidal thoughts

Building on previous research suggesting a cause-and-effect link between mental illness and urinary dysfunction, a new study finds that older men with two or more lower urinary tract symptoms are more likely to have recently had thoughts of suicide.

It's not clear which is more likely to come first-urinary symptoms or suicidal thoughts-nor whether one actually causes the other. Still, the findings suggest that urologists should be alert to the possibility that their patients may suffer from psychological problems, lead study author Benjamin Breyer, MD, MAS, told Urology Times.

"This lends validity to the idea that when you see someone with severe lower urinary tract symptoms, you should screen them for anxiety and depression," said Dr. Breyer, of the University of California, San Francisco. "We should be aware and refer patients when necessary."

Dr. Breyer and colleagues focused on the responses of 2,890 men who took part in the National Health and Nutrition Examination Survey during the 2005-2006 and 2007-2008 cycles. The men were age 40 years or older (mean age, 58) and didn't have a history of prostate cancer.

Forty-three percent of the men reported at least one of these three symptoms: nocturia, urinary hesitancy, and incomplete bladder emptying. Six percent reported two or more symptoms.

In terms of mental illness, 6% reported symptoms that indicated moderate to severe depression, and 4% reported suicidal ideation within the past 2 weeks.

Men with at least two urinary symptoms were more likely to report moderate to severe depression (adjusted odds ratio 3.1, 95% CI: 1.2-8.1) and suicidal ideation (adjusted odds ratio 1.8, 95% CI: 0.9-3.7).

Dr. Breyer, whose study was presented yesterday, said the research expands on previous findings because it looks at suicidal ideation, another indicator of mental illness.