Presentation Authors: Aron Liaw*, San Francisco, CA, Nima Baradaran, Columbus, OH, Kathryn Quanstrom, Benjamin Breyer, Hillary Copp, Lindsay Hampson, San Francisco, CA
Introduction: Adolescents with spina bifida often show delays in community integration and independence, and, as adults, frequently experience social isolation, decreased opportunities, and reduced independence, placing their mental health at risk. Previous studies have identified increased anxiety and depression among adolescents and adults with spina bifida, but there are few consistent predictors of poor mental health in these patients. We hypothesise that similar risks to mental health are seen in patients with congenital urologic conditions that require ongoing care, and seek to characterise those risks and their association with urologic-related quality of life.
Methods: We administered a series of surveys to patients (18+) with congenital urologic conditions. Patient demographics and disease characteristics were collected, along with PROMIS surveys on anxiety, depression, social isolation and resilience as measured by the Connor-Davidson Resilience Scale. Urologic quality of life was measured with the Neurogenic Bladder Symptom Score. PROMIS surveys were scored using the HealthMeasures Scoring Service, with a T-score of 50 representing the median general population, and data analysis done with STATA 15.1.
Results: 271 patients answered the survey questions on mental health. The majority of patients had a diagnosis of spina bifida (91.8%). Mean and median PROMIS t-scores for anxiety and depression were 55 (range 37-82) across the cohort, consistent with at least mild anxiety and depression. Social isolation scores were also above population means. Depression showed significant association (p=0.04) with NBSS quality of life scores, but not with age, household education, race, surgeries, urologic provider type, TRAQ score, or isolation.
Conclusions: Patients with congenital urologic conditions are more socially isolated than the general population, and are at risk for clinically significant anxiety and depression, which was seen in over half this cohort. This risk does not change significantly with demographic characteristics, consistent with previous studies on the subject. Notably, we show a significant association between bladder symptom scores for quality of life and depression in these patients, which underlines the importance of quality urologic care for patients with congenital urologic conditions.