Increased risk of anxiety among patients with urolithiasis: A nationwide population-based cohort study

Abstract

Objectives: To investigate whether patients with urolithiasis are at an increased risk of anxiety and depression.

Methods: We used universal insurance claims data in Taiwan from 2000 to 2011 to identify patients with newly diagnosed urolithiasis (n = 32 617) and those without urolithiasis (n = 130 465). Incidences, hazard ratios, and incidence rate ratios of anxiety and depression were determined in both cohorts in terms of baseline demographic characteristics and comorbidities until December 2011.

Results: The urolithiasis cohort yielded a higher incidence of anxiety (11.9 vs 6.91 per 1000 person-years) with an adjusted hazard ratio of 1.5 (95% confidence interval 1.42-1.57) than the non-urolithiasis cohort. The urolithiasis cohort also showed a higher incidence of depression (5.79 vs 3.95 per 1000 person-years) with an adjusted hazard ratio of 1.26 (95% confidence interval 1.18-1.35) than the non-urolithiasis cohort. Regardless of the patients' baseline comorbidities, patients with urolithiasis showed a higher incidence rate ratio of anxiety and depression than those without urolithiasis (with no comorbidities: adjusted hazard ratio 1.62, 95% confidence interval 1.49-1.76] for anxiety and adjusted hazard ratio 1.37, 95% confidence interval 1.23-1.54 for depression).

Conclusion: Urolithiasis is recurrent, and significantly associated with anxiety and depression. Therefore, urologists should diagnose patients suspected with this disease and provide proper medical care.

Keywords: National Health Insurance program; anxiety; depression; retrospective cohort study; urolithiasis.