Background: Studies demonstrate an association between severe depression and overactive bladder syndrome (OAB).  However, mild depression is constantly overlooked. The aim of this study was to evaluate the clinical and sociodemographic factors associated with mild depression in women with OAB.

Methods: Cross-sectional study involving 241 women over 60 years old in Brasilia, Brazil.  All patients were subjected to an interview followed by questionnaires and physical examination. The clinical and sociodemographic variables analyzed were age, body mass index, physical activity level, OAB symptoms, presence of gynecological surgery, fecal incontinence, systemic arterial hypertension, Diabetes Mellitus, anxiety (Beck Anxiety Scale). The Geriatric Depression Scale-15 (GDS-15) was used to identify depression. Univariate logistic regression was used to assess the correlation between mild depression and the variables chosen. Variables with a p-value less than 0.2 were included in the multivariate logistic regression analysis. The level of confidence was set at 95%.

Results: 121 volunteers suffered from mild depression. The multivariate analysis demonstrated that gynecological surgery (p <.001) and anxiety (p <.001) are factors associated with mild depression. Older women with a history of gynecological surgery and a GDS-15 score of 2.04 were 1.08 times more likely to develop mild depression compared to older women with no history of gynecological  surgery.

Conclusion: Anxiety and a history of gynecological surgery are factors that need to be taken into account and may influence the development of mild depression in older women with OAB. Psychological treatment should be considered an important adjunct in the treatment of women with symptoms of Overactive Bladder Syndrome

We performed a sample calculation using the G Power 3.1.9.2 program with data obtained from a pilot study of 15 elderly women without depressive symptoms and 15 with mild depressive symptoms. Including the independent variables separately, i.e., fecal incontinence and gynecological surgery, and using the presence or absence of symptoms of mild depression as dependent variables for the univariate logistic regression, and considering a power of 90% and an alpha error of 0.05, a sample of 229 participants was determined. We added 5% more to account for data loss, totaling 241 participants.

The non-normal distribution of the data was confirmed by the Kolmogorov-Smirnov test. The categorical data were presented in terms of frequency and percentage. Non-normally distributed continuous data were presented as median and interquartile range (25-75%). Continuous data were compared between the two groups of older women using the Mann-Whitney U test (mild depression and no-mild depression). Categorical data were compared using the Chi-square test. Univariate logistic regression analysis was used to determine the association between each independent variable and the dependent variable (symptoms of depression).

The factors included in the model were age, BMI (continuous variable), physical activity level (active or non-active), fecal incontinence, history of gynecological surgery, SAH, DM, and presence of anxiety (continuous variable). Odds ratios (OR) were calculated for each explanatory variable with 95% confidence intervals. Subsequently, variables that showed a p-value of association of less than 0.20 in the univariate regression analysis were included in the multivariate logistic regression analysis [20]. The best model was selected based on the procedure of reduction of variables, using the enter method. The significance level considered was 0.05. Data analysis was performed using the Statistical Package for Social Sciences (SPSS), version 16.0. The null hypothesis was rejected for P-values <0.05.