Nocturia and depression

OBJECTIVE To assess the possible relationship between major depression (MD) and nocturia. SUBJECTS AND METHODS An unselected group of adult men and women, living in the city of Ostersund, Sweden, were sent a postal questionnaire containing questions on somatic and mental health, sleep, sleepiness and nocturia. For depression diagnostics the Major Depression Inventory (MDI) was used. RESULTS The mean (SD) ages of the men and women were 48.0 (18.2) and 50.1 (19.1) years, respectively. Two or more nocturnal micturition episodes occurred in 15.6% of the men and 16.5% of the women. In a multiple logistic regression analysis independent correlates (with 95% confidence intervals) for greater than or equal to2 nocturnal voids in men were: MD 6.5 (2.6-15.6); health, fair vs good, 1.8 (1.0-3.9); health, poor vs good, 2.7 (1.1-4.8); age, 60-74 vs 18-29, 3.6 (1.5-8.4) and age greater than or equal to75 vs 18-29 6.7 (2.6-17.4); and in women: MD 2.8 (1.3-6.3); health, fair vs good, 1.9 (1.1-3.2); health, poor vs good, 4.3 (2.6-8.2); age, 60-74 vs 18-29, 3.8 (1.8-7.8), and age greater than or equal to75 vs 18-29, 8.6 (4.0-18.6). Age < 60 years was deleted by the logistic model in both sexes. CONCLUSION MD is associated with a six-fold increase in nocturia in men and a three-fold increase in women, after accounting for age and health. Possible pathogenetic mechanisms of this relationship may involve both increased nocturnal diuresis via a disturbed 24-h rhythm of antidiuretic hormone secretion, and a decrease in nocturnal bladder capacity through a central and/or peripheral serotonergic effect.