����������

���������� Note: We know that individuals with mental health challenges—particularly those treated with psychopharmacology for serious diagnoses—have a higher risk of certain physical health challenges, including heart disease and diabetes, but also often overlooked or under-documented issues like bladder and digestion issues. The article below describes one study correlating overactive bladder in female war veterans with multiple distinct psychiatric diagnoses. The researcher describes interesting contributing factors, however, that reinforces a significant shift in how researchers and treatment professionals are looking at the connection between mind and body. Not only does the research look at the possible correlation between psychiatric disabilities and a potentially unrelated health issues, but it draws possible conclusions that do not stigmatize mental health through an assumption that poor mental health would contribute to a person’s inability to treat or mitigate a physical health problem. It goes on to suggest that while contributing factors to the correlation may be social, there are also biological issues affecting serotonergic and pituitary-adrenal system responses that may be contributing to both the problems and the correlation. Essentially, they are acknowledging that inflammation and epigenetic factors that lead to hormonal imbalances may be contributing to the problem. This has exciting implications for a growing body of evidence supporting the hypothesis that hormonal disruptions in our endocrine system—causing inflammation that leads to bodily imbalances—may be an effective point of treatment for persons experiencing even severe mental health challenges.

��

• Janna Lyford; medwireNews, 5/6/2014
• ��

��(OAB) symptoms are present in nearly one in four female veterans returning from overseas military service, US researchers say.

Their longitudinal analysis of participants in the Women Veterans Urinary Health Study also found an association between OAB and mental health issues such as�� and post-traumatic stress disorder (PTSD).

“Given these findings, OAB screening in patients with mental health conditions and vice versa may increase opportunities for the diagnosis and treatment of both sets of bothersome conditions”, write Catherine Bradley (University of Iowa Hospitals & Clinics, Iowa City, USA) and colleagues in the��Journal of��.

The study enrolled 1702 women who in the previous 2 years had returned from deployment in Iraq and Afghanistan. The women were interviewed by telephone.

The women’s mean age was just 31.1 years and they were of diverse race/ethnicity: 59.1% were White, 21.2% were Black, 11.5% were Hispanic and 4.5% were Asian. Most women had served in the army and 17% were officers.

The overall prevalence of bothersome OAB symptoms was 22%, which is around twice the rate that would be expected in an age- and gender-matched general population, say the study authors.

Women with OAB were significantly older, weighed more and were more likely to be Black than women without this symptom, the researchers report. They also had higher parity and were significantly less likely to describe themselves as being in “excellent” or “very good” general health.

The overall prevalence of PTSD, depression and����was 19%, 10% and 21%, respectively, while 27% reported a history of sexual assault.

Interestingly, all four of these factors were significantly more frequent in women with OAB than in those without; rates were 37.8% versus 13.8% for PTSD, 20.5% versus 7.0% for depression, 40.6% versus 16.0% for anxiety, and 37.0% versus 24.4% for sexual assault.

Each of the psychiatric diagnoses remained significantly associated with OAB after adjusting for covariates, with odds ratios of 2.7, 2.7, 2.5 and 1.4 for PTSD, depression, anxiety, and sexual assault, respectively.

The presence of mental health symptoms was also associated with a greater severity of urinary symptom bother on the Urogenital Distress Inventory and functional impact on the Incontinence IIQ-7 (Impact Questionnaire Short Form).

Bradley’s team says that there are several putative functional, social and biological mechanisms that may underlie the association between mental ill health and OAB. Dysfunction in serotonergic and pituitary–adrenal systems have been proposed as possible pathophysiological mechanisms; alternatively, low-grade inflammation may be a common underlying cause.

The team concludes: “Screening and evaluation for bothersome urinary symptoms and mental health problems appear warranted in female veterans presenting for primary and urological care after deployment.”

��