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Quality of Life Research

, Volume 25, Issue 9, pp 2307–2314 | Cite as

Anxiety and depression analyses of patients undergoing diagnostic cystoscopy

  • Stephan Seklehner
  • Paul Friedrich Engelhardt
  • Mesut Remzi
  • Harun Fajkovic
  • Zana Saratlija-Novakovic
  • Matthias Skopek
  • Irene Resch
  • Mario Duvnjak
  • Stephan Hruby
  • Clemens Wehrberger
  • Davor Librenjak
  • Wilhelm Hübner
  • Eckart Breinl
  • Claus Riedl
Article

Abstract

Purpose

To prospectively assess anxiety and depression in patients undergoing diagnostic cystoscopy.

Methods

Patients presenting for outpatient diagnostic cystoscopy were recruited from four European urological departments. Anxiety and depression were assessed with the ‘Hospital Anxiety and Depression Scale’ (HADS) before cystoscopy and after 1 week. Statistical analyses, including the Chi-square test, univariate, and multivariate logistic regression analyses, were carried out with SPSS v. 21 (IBM Corp., Armonk, NY).

Results

Prior to cystoscopy, 30.2 % of patients were anxious and 24.8 % depressive (n = 442). In the post-examination period, anxiety declined to 24.5 %, while depression was unchanged (24.4 %). Pre-cystoscopy anxiety was significantly more common in women (41.8 vs. 24.5 %, p < 0.0001), patients aged <65 years (34.9 vs. 25.9 %, p = 0.04), and in those being examined with rigid cystoscopes (35.7 vs. 23.9 %, p = 0.007). In multivariate regression analyses, female gender (OR 2.6, p < 0.0001), <65 years of age (OR 1.7, p = 0.03), and coexistence of depression (OR 7.8, p < 0.0001) were independently associated with elevated pre-cystoscopy anxiety. Anxious (OR 2.1, p = 0.03) and depressive (OR 2.1, p = 0.01) patients had higher odds of experiencing moderate or severe pain during cystoscopy. Bladder cancer diagnosis did not significantly change patient’s anxiety (p = 0.23) or depression (p = 0.7) during the 1 week of follow-up.

Conclusions

Women, patients aged <65 years, depressive patients and those being examined with rigid devices had higher rates of anxiety prior to cystoscopy. Anxious and depressive patients experienced more pain during cystoscopy. Bladder cancer diagnosis seems to have a minor effect on anxiety and depression during the first week after diagnosis.

Keywords

Cystoscopy Anxiety Depression Diagnostic techniques, urological Pain 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Babjuk, M., Burger, M., Zigeuner, R., et al. (2013). EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: Update 2013. European Urology, 64, 639–653.CrossRefPubMedGoogle Scholar
  2. 2.
    Burger, M., Catto, J. W., Dalbagni, G., et al. (2013). Epidemiology and risk factors of urothelial bladder cancer. European Urology, 63, 234–241.CrossRefPubMedGoogle Scholar
  3. 3.
    Means-Christensen, A. J., Roy-Byrne, P. P., Sherbourne, C. D., Craske, M. G., & Stein, M. B. (2008). Relationships among pain, anxiety, and depression in primary care. Depression and Anxiety, 25, 593–600.CrossRefPubMedGoogle Scholar
  4. 4.
    Hinz, A., Krauss, O., Hauss, J. P., et al. (2010). Anxiety and depression in cancer patients compared with the general population. Eur J Cancer Care (Engl)., 19, 522–529.CrossRefGoogle Scholar
  5. 5.
    Palapattu, G. S., Haisfield-Wolfe, M. E., Walker, J. M., et al. (2004). Assessment of perioperative psychological distress in patients undergoing radical cystectomy for bladder cancer. Journal of Urology, 172, 1814–1817.CrossRefPubMedGoogle Scholar
  6. 6.
    Mansson, A., Davidsson, T., Hunt, S., & Mansson, W. (2002). The quality of life in men after radical cystectomy with a continent cutaneous diversion or orthotopic bladder substitution: Is there a difference? BJU International, 90, 386–390.CrossRefPubMedGoogle Scholar
  7. 7.
    Benner, C., Greenberg, M., Shepard, N., Meng, M. V., & Rabow, M. W. (2014). The natural history of symptoms and distress in patients and families following cystectomy for treatment of muscle invasive bladder cancer. Journal of Urology, 191, 937–942.CrossRefPubMedGoogle Scholar
  8. 8.
    Goossens-Laan, C. A., Kil, P. J., Ruud Bosch, J. L., & De Vries, J. (2013). Pre-diagnosis quality of life (QoL) in patients with hematuria: Comparison of bladder cancer with other causes. Quality of Life Research, 22, 309–315.CrossRefPubMedGoogle Scholar
  9. 9.
    Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefPubMedGoogle Scholar
  10. 10.
    Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the hospital anxiety and depression scale. An updated literature review. Journal of Psychosomatic Research, 52, 69–77.CrossRefPubMedGoogle Scholar
  11. 11.
    Berard, R. M., Boermeester, F., & Viljoen, G. (1998). Depressive disorders in an out-patient oncology setting: Prevalence, assessment, and management. Psychooncology, 7, 112–120.CrossRefPubMedGoogle Scholar
  12. 12.
    Ene, K. W., Nordberg, G., Johansson, F. G., & Sjostrom, B. (2006). Pain, psychological distress and health-related quality of life at baseline and 3 months after radical prostatectomy. BMC Nursing, 5, 8.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    De Smedt, D., Clays, E., Doyle, F., et al. (2013). Validity and reliability of three commonly used quality of life measures in a large European population of coronary heart disease patients. International Journal of Cardiology, 1(167), 2294–2299.CrossRefGoogle Scholar
  14. 14.
    Herrmann, C., & Buss, U. (1994). Vorstellung und Validierung einer deutschen Version der “Hospital Anxiety and Depression Scale” (HAD-Skala); ein Fragebogen zur Erfassung des psychischen Befindens bei Patienten mit körperlichen Beschwerden. Diagnostica, 40, 143–154.Google Scholar
  15. 15.
    Herrmann, C. (1997). International experiences with the hospital anxiety and depression scale: A review of validation data and clinical results. Journal of Psychosomatic Research, 42, 17–41.CrossRefPubMedGoogle Scholar
  16. 16.
    Pokrajac-Bulian, A., Ambrosi-Randić, N., & Kukić, M. (2008). Thin-ideal internalization and comparison process as mediators of social influence and psychological functioning in the development of disturbed eating habits in croatian college females. Psychological Topics, 17, 221–245.Google Scholar
  17. 17.
    Nunnally, J. C., & Bernstein, I. (1994). Psychometric theory (3rd ed.). New York: McGraw-Hill.Google Scholar
  18. 18.
    Hinz, A., & Brahler, E. (2011). Normative values for the hospital anxiety and depression scale (HADS) in the general German population. Journal of Psychosomatic Research, 71, 74–78.CrossRefPubMedGoogle Scholar
  19. 19.
    Hinz, A., Finck, C., Gomez, Y., Daig, I., Glaesmer, H., & Singer, S. (2014). Anxiety and depression in the general population in Colombia: Reference values of the hospital anxiety and depression scale (HADS). Social Psychiatry and Psychiatric Epidemiology, 49, 41–49.CrossRefPubMedGoogle Scholar
  20. 20.
    Jorngarden, A., Wettergen, L., & von Essen, L. (2006). Measuring health-related quality of life in adolescents and young adults: Swedish normative data for the SF-36 and the HADS, and the influence of age, gender, and method of administration. Health Quality of Life Outcomes, 4, 91.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Stordal, E., Bjartveit Kruger, M., Dahl, N. H., Kruger, O., Mykletun, A., & Dahl, A. A. (2001). Depression in relation to age and gender in the general population: the Nord-Trondelag Health Study (HUNT). Acta Psychiatrica Scandinavica, 104, 210–216.CrossRefPubMedGoogle Scholar
  22. 22.
    Breeman, S., Cotton, S., Fielding, S., & Jones, G. T. (2015). Normative data for the hospital anxiety and depression scale. Quality of Life Research, 24, 391–398.CrossRefPubMedGoogle Scholar
  23. 23.
    Seklehner, S., Hladschik-Kermer, B., Lusuardi, L., Schabauer, C., Riedl, C., & Engelhardt, P. F. (2013). Psychological stress assessment of patients suffering from prostate cancer. Scandinavian Journal of Urology, 47, 101–107.CrossRefPubMedGoogle Scholar
  24. 24.
    Seklehner, S., Remzi, M., Fajkovic, H., et al. (2015). Prospective multi-institutional study analyzing pain perception of flexible and rigid cystoscopy in men. Urology, 85, 737–741.CrossRefPubMedGoogle Scholar
  25. 25.
    Zhang, Z. S., Wang, X. L., Xu, C. L., et al. (2014). Music reduces panic: An initial study of listening to preferred music improves male patient discomfort and anxiety during flexible cystoscopy. Journal of Endourology, 28, 739–744.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Kesari, D., Kovisman, V., Cytron, S., & Benjamin, J. (2003). Effects on pain and anxiety of patients viewing their cystoscopy in addition to a detailed explanation: A controlled study. BJU International, 92, 751–752.CrossRefPubMedGoogle Scholar
  27. 27.
    Walker, M. R., Kallingal, G. J., Musser, J. E., Folen, R., Stetz, M. C., & Clark, J. Y. (2014). Treatment efficacy of virtual reality distraction in the reduction of pain and anxiety during cystoscopy. Military Medicine, 179, 891–896.CrossRefPubMedGoogle Scholar
  28. 28.
    Wong, W. S., & Fielding, R. (2010). Prevalence of chronic fatigue among Chinese adults in Hong Kong: A population-based study. Journal of Affective Disorders, 127, 248–256.CrossRefPubMedGoogle Scholar
  29. 29.
    DiMatteo, M. R., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine, 24(160), 2101–2107.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Stephan Seklehner
    • 1
  • Paul Friedrich Engelhardt
    • 1
    • 2
  • Mesut Remzi
    • 3
  • Harun Fajkovic
    • 4
    • 5
  • Zana Saratlija-Novakovic
    • 6
  • Matthias Skopek
    • 3
  • Irene Resch
    • 4
  • Mario Duvnjak
    • 6
  • Stephan Hruby
    • 2
  • Clemens Wehrberger
    • 7
  • Davor Librenjak
    • 6
  • Wilhelm Hübner
    • 3
  • Eckart Breinl
    • 4
  • Claus Riedl
    • 1
  1. 1.Department of UrologyLandesklinikum Baden-MödlingBadenAustria
  2. 2.Department of UrologyParacelsus Medical University SalzburgSalzburgAustria
  3. 3.Department of UrologyLandesklinikum KorneuburgKorneuburgAustria
  4. 4.Department of UrologyUniversitätsklinikum Sankt PöltenSt. PöltenAustria
  5. 5.Department of Urology, Comprehensive Cancer CenterMedical University of Vienna, Vienna General HospitalViennaAustria
  6. 6.Department of UrologyKlinički Bolnički Centar SplitSplitCroatia
  7. 7.Department of UrologyDonauspital ViennaViennaAustria

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