Introduction and hypothesis: Previous studies report higher prevalence of depression among women with urgency (UUI) or mixed (MUI) urinary incontinence than those with stress UI (SUI). UUI is the dominant type among black women, whereas SUI is the predominant type among white women. Thus, UI-related mental health issues could be a key consideration among black women. We hypothesized that the association between UI and depression might be stronger in black versus white women.
Methods: These cross-sectional analyses assessed 934 black and 71,161 white women aged 58-83 in the Nurses' Health Study, which was established among women living in the USA. Depressive symptoms were assessed using the ten-item Center for Epidemiologic Studies Depression Scale (CESD-10). Multivariate adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) for high depressive symptoms (CESD-10 score ≥ 10) according to self-reported UI frequency, severity, and type were calculated using logistic regression models.
Results: Although point estimates for associations of UI frequency, severity, and type with high depressive symptoms were higher in black women, differences in ORs between black versus white women were not statistically significant. For example, the OR for at least weekly UI compared with no UI was 2.29 (95 % CI 1.30-4.01) in black women and 1.58 (95 % CI 1.49-1.68) in white women (p interaction = 0.4).
Conclusions: We found no statistically significant differences in UI frequency, severity, and type with high depressive symptoms in black versus white women. However, the small number of black women in this study with high depressive symptoms limited statistical power to detect significant interactions. Thus, these results should be interpreted with caution.