Interactions Between Depression and Lower Urinary Tract Symptoms: The Role of Adverse Life Events and Inflammatory Mechanisms. Results From the European Male Ageing Study. Issue 6 (July 2016)

• Record Type: Journal Article
• Authors: Castellini, Giovanni; Wu, Frederick C.W.; Finn, Joseph D.; O'Neill, Terrence W.; Lean, Michael E.J.; Pendleton, Neil; Rastrelli, Giulia; Rutter, Martin K.; Gacci, Mauro; Ricca, Valdo; Maggi, Mario
• Is Part Of: Psychosomatic medicine. Volume 78:Issue 6(2016)
• Publication Date: 2016-07
• Subjects: aging -- depression -- lower urinary tract symptoms -- adverse life events -- C-reactive protein -- BDI-II = Beck Depression Inventory-II -- CRP = C-reactive protein -- EMAS = European Male Ageing Study -- GLM = general linear model -- HPA axis = hypothalamic-pituitary-gonadal axis -- IPSS = International Prostate Symptom Score -- LUTS = lower urinary tract symptoms -- PASE = Physical Activity Scale for the Elderly -- PSA = prostate-specific antigen -- SF-36 = Short Form survey; Medicine, Psychosomatic -- Periodicals; 616.0805
• DOI: 10.1097/PSY.0000000000000328
• Languages: English
• ISSNs: 0033-3174

Abstract

ABSTRACT: Objectives: Depression and lower urinary tract symptoms (LUTSs) have been found to co-occur among aging men. The present study attempted to clarify the nature of this relationship, considering adverse life events as potential moderators and the inflammation as an underlying biological mechanism. Methods: The relationship between depression and LUTS was evaluated using data from the European Male Ageing Study, the largest multicenter population-based study of aging in European men. The sample included 3369 men who were assessed by means of several self-reported questionnaires, including the Beck Depression Inventory-II, the International Prostate Symptom Score, and the Adverse Life Events Scale. Participants were asked to provide information regarding general health and life-style, and medical comorbidities. Biological measures including prostate-specific antigen, testosterone, and C-reactive protein were measured. Results: LUTS and depressive symptoms were correlated ( R 2 = 0.32, β = .10, p < .001), even after adjusting for life-style, psychological, and medical variables. A history of adverse life events was associated with both higher LUTS and Beck Depression Inventory scores. Furthermore, adverse life events moderated the LUTS-depression association ( F = 22.62, b = 0.061, p < .001), which increased as a function of the number of life events. C-reactive protein was found to mediate the LUTS-depression association. This mediation effect was moderated by number of adverse life events. Conclusions: Participants with a history of adverse life events represent a vulnerable population in whom the association between somatic and depressive symptoms is stronger. One of the biological mechanisms underlying this association could be an activation of the central inflammatory signaling pathways.