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

PurposeThe relationship between lower urinary tract symptoms and depressive symptoms was assessed using data from the Male Attitudes Regarding Sexual Health study.Materials and MethodsLower 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.ResultsOf 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).ConclusionsLower urinary tract symptoms and depressive symptoms are strongly associated, and exhibit reciprocal relationships. Erectile dysfunction increases the odds of both disorders.