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Anxiety and depression analyses of patients undergoing diagnostic cystoscopy

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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.

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Authors and Affiliations

  1. Department of Urology, Landesklinikum Baden-Mödling, Baden, Austria

    Stephan Seklehner, Paul Friedrich Engelhardt & Claus Riedl

  2. Department of Urology, Paracelsus Medical University Salzburg, Salzburg, Austria

    Paul Friedrich Engelhardt & Stephan Hruby

  3. Department of Urology, Landesklinikum Korneuburg, Korneuburg, Austria

    Mesut Remzi, Matthias Skopek & Wilhelm Hübner

  4. Department of Urology, Universitätsklinikum Sankt Pölten, St. Pölten, Austria

    Harun Fajkovic, Irene Resch & Eckart Breinl

  5. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria

    Harun Fajkovic

  6. Department of Urology, Klinički Bolnički Centar Split, Split, Croatia

    Zana Saratlija-Novakovic, Mario Duvnjak & Davor Librenjak

  7. Department of Urology, Donauspital Vienna, Vienna, Austria

    Clemens Wehrberger

Authors
  1. Stephan Seklehner
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  2. Paul Friedrich Engelhardt
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Corresponding author

Correspondence to Stephan Seklehner.

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All authors declare that they have no conflict of interest.

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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.

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Seklehner, S., Engelhardt, P.F., Remzi, M. et al. Anxiety and depression analyses of patients undergoing diagnostic cystoscopy. Qual Life Res 25, 2307–2314 (2016). https://doi.org/10.1007/s11136-016-1264-z

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