Longitudinal study of the relationship between lower urinary tract symptoms and depressive symptoms

Objective: To analyze the longitudinal association between lower urinary tract symptoms (LUTS) and the development of incident depressive symptoms in Korean men. Methods: This study initially recruited 16,155 Korean men who underwent routine health examinations between 2005 and 2012, and completed the International Prostate Symptom Score (IPSS) screening tool and Beck Depression Inventory-1 (BDI). The final study population included 9080 men, aged 15-89, who had a baseline BDI score < 10 and follow-up BDI data, with no history of depression, bladder or prostate operations. Cox proportional hazard models were used to assess the relationship between LUTS and the development of incident depressive symptoms. Multiple imputation was used to handle missing values. Results: After adjusting for significant covariates, LUTS were associated longitudinally with the development of incident depressive symptoms (hazard ratio [HR] = 1.81 [95% confidence interval [CI] = 1.26-2.61]). An analysis of the specific domains of LUTS revealed that voiding LUTS (HR = 1.58 [95% CI = 1.07-2.33]), but not storage LUTS (HR = 1.43 [95% CI = 0.96-2.13]), were associated longitudinally with depressive symptoms. Conclusion: LUTS and voiding LUTS, but not storage LUTS, were associated longitudinally with incident depressive symptoms.