Self-harm and depression in women with urinary incontinence: a record-linkage study.
Goldacre MJ., Abisgold JD., Yeates DG., Voss S., Seagroatt V.
OBJECTIVE: To investigate the association between self-harm and urinary incontinence (UI), and between depression and UI, in women. PATIENTS AND METHODS: The incidence of self-harm in women with UI is not well documented. We analysed a statistical database that includes hospital contact data for UI and for self-harm and depression. We calculated rate ratios for self-harm and depression in a cohort of women admitted for UI, and rate ratios for UI in cohorts of women admitted with self-harm or depression, compared with a control cohort. RESULTS: After admission for UI, self-harm was significantly high in young women (aged < 45 years: rate ratio 1.73, 95% confidence intervals 1.37-2.14) but not in older women. Depression was associated with UI in all age groups, e.g. after admission for depression the rate ratio for UI within 5 years was 1.46 (1.33-1.75); and for UI at > or = 5 years after admission for depression, it was 1.20 (1.05-1.35). CONCLUSIONS: Young women with UI are at risk of self-harm. For all age groups studied, depression was more common in women with UI than in others. Depression might be a consequence of UI, but the increase in risk at long intervals before admission with UI suggests that they might share underlying causal mechanisms.