Stress and Anxiety Effects on Overactive Bladder: A Controlled Study

压力和焦虑对膀胱过度活动症的影响：一项对照研究

基本信息

批准号：
10676251
负责人：
William Stuart Reynolds
金额：
$ 39.81万
依托单位：
VANDERBILT UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-15 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10676251
关键词：
Acute Adopted Affect Animals Anxiety Area Behavior Behavioral Bladder Clinical Trials Containment Controlled Study Coping Behavior Cross-Sectional Studies Development Discipline Disease Distress Ecological momentary assessment Electronics Esthesia Frequencies Future Generalized Anxiety Disorder Genitourinary system Goals Health Human Hydration status Hypersensitivity Impairment Incontinence Individual Interdisciplinary Study Intervention Knowledge Laboratories Learning Left Life Link Liquid substance Maps Measures Mediating Methods Modeling Nocturia Oral Outcome Overactive Bladder Pain Research Pathway interactions Patients Pattern Persons Physiological Procedures Process Psychological Factors Psychological Stress Psychology Public Health Quality of life Research Role Sampling Scientific Advances and Accomplishments Self Management Side Strategic Planning Stress Symptoms Testing Time Travel Urinary Incontinence Urology Woman acute stress anxiety symptoms behavioral impairment chronic pain coping diaries generalized anxiety improved innovation men meter micturition urgency novel perceived stress personalized care prospective psychologic psychological stressor response self help stress reactivity stress symptom urinary

项目摘要

PROJECT SUMMARY Overactive bladder (OAB) (i.e. urinary urgency, with or without urgency urinary incontinence, frequency, and nocturia) affects 1 in 7 U.S. men and women and results in substantial impairment to quality of life (QOL). To help self-manage and cope with OAB, many people adopt compensatory bladder behaviors, such as restricting fluids, using containment products, strategic planning and mapping restroom access, and even curtailing activities or travel altogether, which further adversely impact QOL. These behaviors may be driven by anxiety and stress related to urinary urgency and incontinence episodes as well as ensuing distress and embarrassment. Prior research has linked anxiety and OAB: up to 40% of women and 30% of men with OAB also have generalized anxiety disorder. The link between stress and OAB is less studied. In animals, experimental stress can cause OAB-like symptoms and behaviors as well as bladder and somatic hypersensitivity. In limited human studies, women with OAB may have greater physiologic and psychologic stress reactivity, and acute stress may exacerbate urinary urgency. However, how stress impacts on the bladder in the context of OAB or what psychological factors drive compensatory behaviors that impair QOL in OAB remain unknown, as there are no highly-controlled studies of anxiety-OAB links. Understanding these relationships would be a critical advance to individualizing care of patients with OAB. The proposed project will comprehensively investigate for the first time how stress, anxiety and OAB interact, including the impacts on bladder sensitivity, urinary symptoms, and compensatory bladder behaviors. We propose a feedforward loop, whereby increased OAB symptoms increase anxiety (via response to coping with stressful situations), which in turn increases OAB symptoms (via increased bladder sensitivity). We further propose that compensatory behaviors are driven by anxiety-related learning processes that help perpetuate this relationship. We will test our hypotheses in a sample of men and women with OAB and healthy controls. Aim 1 will test the hypothesis that acute, experimentally induced psychological stress will be more strongly associated with increased bladder sensitivity in OAB patients than in controls, using a novel bladder sensation meter with oral hydration and stress induction procedures. Aim will test the hypothesis that psychological stress and anxiety will have concurrent and lagged effects on day-to-day urinary symptoms that are stronger in individuals with OAB than in controls, using an ecological momentary assessment approach (7-day electronic diary) to examine prospective associations between everyday perceived stress, anxiety and urinary symptoms. Aim 3 will test the hypothesis that compensatory behaviors (i.e. coping) used at the time of voiding will be associated with subsequent reductions in anxiety levels, using a 3-day sensation-related bladder diary that captures concurrent bladder behaviors and anxiety symptoms as well as lagged symptoms 30 minutes post-void. Delineating these relationships and patterns will allow for identification of potentially modifiable factors or areas for intervention, which we envision as a future R01 clinical trial submission.

项目概要膀胱过度活动症 (OAB)（即尿急，伴或不伴急迫性尿失禁、尿频和尿失禁）夜尿症）影响七分之一的美国男性和女性，并导致生活质量 (QOL) 严重受损。到为了帮助自我管理和应对 OAB，许多人采取代偿性膀胱行为，例如限制膀胱液体、使用密封产品、战略规划和绘制卫生间通道图，甚至减少活动或旅行，这进一步对生活质量产生不利影响。这些行为可能是由焦虑引起的与尿急和尿失禁发作相关的压力以及随之而来的痛苦和尴尬。先前的研究已将焦虑与 OAB 联系起来：高达 40% 的女性和 30% 的男性患有 OAB 广泛性焦虑症。压力与 OAB 之间的联系研究较少。在动物中，实验应激可引起 OAB 样症状和行为以及膀胱和躯体过敏。在有限的人力研究表明，患有 OAB 的女性可能有更大的生理和心理应激反应性，并且急性应激可能加剧尿急。然而，在 OAB 的情况下，压力如何影响膀胱？心理因素驱动损害 OAB 患者生活质量的补偿行为仍然未知，因为没有焦虑与 OAB 联系的高度对照研究。理解这些关系将是一个关键的进步 OAB 患者的个体化护理。拟建项目将首次综合考察压力、焦虑和 OAB 如何相互作用，包括对膀胱敏感性、泌尿系统症状和膀胱代偿行为。我们提出了一个前馈循环，通过该循环，OAB 症状会增加焦虑（通过应对压力情况的反应），这反过来又会增加 OAB 症状（通过增加膀胱敏感性）。我们进一步提出补偿行为是由焦虑相关的学习驱动的有助于维持这种关系的流程。我们将在男性和女性样本中检验我们的假设具有 OAB 和健康对照。目标 1 将检验以下假设：急性的、实验诱发的心理与对照组相比，OAB 患者的压力与膀胱敏感性增加的相关性更强，使用一种新型膀胱感觉计，具有口服水合和压力诱导程序。目标将检验假设心理压力和焦虑会对日常泌尿症状产生同步和滞后的影响使用生态瞬时评估方法，OAB 个体比对照组更强（7 天电子日记）检查日常感知的压力、焦虑和泌尿系统症状。目标 3 将检验以下假设：在发生事件时使用的补偿行为（即应对行为）使用 3 天的感觉相关膀胱，排尿与随后的焦虑水平降低相关记录并发膀胱行为和焦虑症状以及滞后症状的日记 30 分钟后无效。描述这些关系和模式将允许识别潜在的可修改因素或干预领域，我们设想将其作为未来 R01 临床试验的提交。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Recurrent urinary tract infection management and prevention techniques among a population-based cohort of women.

基于人群的女性群体中复发性尿路感染的管理和预防技术。

DOI：
10.1002/nau.25281
发表时间：
2023
期刊：
Neurourology and urodynamics
影响因子：
2
作者：
Gleicher,Stephanie;Sebesta,ElisabethM;Kaufman,MelissaR;Dmochowski,RogerR;Reynolds,WilliamStuart
通讯作者：
Reynolds,WilliamStuart

Associations Between Unmet Social Needs and Overactive Bladder.

DOI：
10.1097/ju.0000000000002841
发表时间：
2022-11
期刊：
JOURNAL OF UROLOGY
影响因子：
6.6
作者：
Sebesta, Elisabeth M. M.;Gleicher, Stephanie;Kaufman, Melissa R. R.;Dmochowski, Roger R. R.;Reynolds, W. Stuart
通讯作者：
Reynolds, W. Stuart

The burdens of incontinence: Quantifying incontinence product usage and costs in women.