Psychological Distress in Patients With Urolithiasis: A Systematic Review and Meta-analysis

Purpose:Urolithiasis can be a painful condition associated with significant individual and health care burdens. Several studies have shown that anxiety and depression, termed psychological distress, may be associated with urolithiasis. However, there is little consensus on this relationship. We performed a systematic review and meta-analysis on the relationship between urolithiasis and psychological distress and examined rates of psychological distress in this population.Materials and Methods:We searched online databases including MEDLINE (via PubMed), Embase (via Ovid), Web of Science, and the Cochrane Library with predefined search criteria up to March 2022 utilizing the Preferred Reporting Items for Systematic Review and Meta-analyses. Forty-nine peer-reviewed publications were included in this review. We performed a narrative synthesis on included studies, and a random-effects meta-analysis to obtain a single summary estimate for the relationship between urolithiasis and anxiety.Results:Narrative synthesis found evidence for a relationship between urolithiasis and psychological distress, both anxiety and depression. Meta-analysis of 7 studies found a moderate pooled association between urolithiasis and state anxiety. Additionally, higher proportions of urolithiasis patients experienced psychological distress compared to nonurolithiasis samples across studies. Our findings are limited by the observed heterogeneity in assessment protocols within the data set.Conclusions:Our findings suggest a moderate but significant association between anxiety and urolithiasis, as well as a greater than expected number of urolithiasis patients experiencing psychological distress. More high-quality research studies are required to better understand factors that may influence the relationship between urolithiasis and psychological distress.