Abstract
The available data about the hypothesis that psychological conditions cause urinary incontinence are contradictory. This study was based on a group of patients undergoing urodynamic investigation to define the type of incontinence. Patients were submitted to a battery of psychological tests, including STAXI, CES-D and IBQ (in their Italian version). Patients suffering from urge incontinence showed higher degrees of inner anger and anger trait than those suffering from stress or mixed incontinence. Neither group showed signs of depression. The conviction of illness was greatest in patients suffering from stress or mixed incontinence, whereas irritability and general hypochondria prevailed in patients suffering from urge incontinence. Such patients tend to develop psychosomatic reactions that may contribute to the severity of their symptoms.
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Editorial Comment: Understanding a patient's perception of their incontinence and ability to cope with symptoms is an important aspect of a clinician's ability to educate the patient and treat their incontinence successfully. This is particularly true when using behavioral therapies, where the patient's understanding of the cause of their incontinence and their own volitional control of the lower urinary tract directly affects success. The investigators find that patients with DI experience more internally driven rage, which is poorly expressed, and a higher incidence of irritability and hypochondria than patients with GSI or mixed incontinence. This overall increased inner frustration may stand in the way of learning to deal with and overcome uncontrolled activity. It behooves the clinician to address this frustration in a compassionate and caring yet direct manner to maximize the patient's compliance to therapy, thus improving their chance of regaining bladder control.
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Chiara, G., Piccioni, V., Perino, M. et al. Psychological investigation in female patients suffering from urinary incontinence. Int Urogynecol J 9, 73–77 (1998). https://doi.org/10.1007/BF01982211
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DOI: https://doi.org/10.1007/BF01982211