The relationship between mental health disorders and LUTS

This narrative review explores the complex relationship between lower urinary tract symptoms (LUTS) and mental health disorders, focusing on the influence of anxiety and depression on bladder function. Historical perspectives highlight early psychoanalytic theories, with renewed research underscoring the link between psychiatric conditions such as anxiety, depression, and obsessive-compulsive disorder (OCD), which is closely related to anxiety and various LUTS, including urinary incontinence (UI), overactive bladder (OAB), voiding dysfunction, and nocturia. Although the exact causal mechanisms remain unclear, the association between LUTS and mental health disorders is complex, involving shared neurological, neurochemical, and inflammatory pathways. The bladder-brain axis (BBA) explains how psychological stressors and physical threats contribute to alarm falsification, enhancing symptom severity and distress. There is a bidirectional relationship between mental health disorders and LUTS which emphasizes the need for a multidisciplinary approach to diagnosis and treatment. Especially because mental health disorders can significantly worsen treatment outcome and treatment adherence. Finally, this review highlights promising directions for future research, including the use of emerging approaches such as artificial intelligence (AI) and ecological momentary assessment (EMA). These tools offer potential for real-time monitoring and personalized treatment, addressing the limitations of retrospective assessment and improving patient care.