Anxiety Plus Overactive Bladder Tied to Biopsychosocial Impacts in Women

Women report psychological stress, stress reactivity, and worse quality of life, plus greater central sensitization

By Lori Solomon HealthDay Reporter

MONDAY, March 6, 2023 (HealthDay News) — Women with overactive bladder (OAB) and at least mild anxiety symptoms report greater psychosocial burdens, according to a study published online Feb. 13 in Neurology Urodynamics.

William S. Reynolds, M.D., from the Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues examined the effect of anxiety on OAB with a specific focus on bladder hypersensitivity. The analysis included 120 women with OAB and focused on patient‐reported urinary symptom severity and quality of life, psychological stress symptoms, general somatic symptoms, and results of quantitative sensory testing, including temporal summation to heat pain.

The researchers found that 30 percent of women had at least mild anxiety. There were no group differences observed for urinary symptom severity; however, more anxious women reported worse OAB-specific quality of life, greater psychological stress burden, higher stress reactivity, and greater somatic symptoms. There were no differences seen between anxiety groups for pain threshold and tolerance on quantitative sensory testing. However, temporal summation to heat pain was higher among women with anxiety versus women without anxiety, indicating greater central sensitization.

“A key novel finding in the current study is that women with OAB and anxiety demonstrated elevated temporal summation to heat pain relative to those without anxiety,” the authors write. “Elevated temporal summation to heat pain is an objective marker of central sensitization to C‐fiber input, so our findings support a potential role for central sensitization as a pathophysiologic mechanism contributing to OAB in those with greater psychological burden.”

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