Approved Research

Mental health and incontinence

Lay summary

It is commonly believed that incontinence affects only young children and the elderly, but it can affect people of all ages. Incontinence has debilitating effects on quality of life and has been described as "not life threatening, but life ruining". Despite the high prevalence and adverse effects of incontinence, research into the causes, prevention and treatment of incontinence is lacking.

Clinicians recognise that incontinence is strongly associated with mental health problems, but previous research has been unable to establish whether poor mental health is a cause or consequence of incontinence.  There is also some evidence that stressful life events and adverse childhood experiences (ACEs) are associated with an increased risk of incontinence in adulthood.

This 33-month project, funded by the Medical Research Council will examine whether mental health problems and adverse experiences in childhood and adulthood are associated with an increased risk of incontinence. We will apply novel and robust statistical methods to test whether (i) mental health problems (depression, anxiety) cause incontinence and if (ii) incontinence causes mental health problems.

Clinicians who treat incontinence recognise the need to prioritise research into its relationship with mental health problems and adverse experiences, because this knowledge will help them to manage their patients more effectively. People with incontinence feel strongly that there is a connection with their mental health, but mental health problems are often ignored or inadequately assessed by clinicians who treat incontinence. Our research will help clinicians to develop preventative interventions and effective therapies for incontinence. Our work will also contribute to the design of care pathways that integrate mental and physical healthcare for patients with incontinence. This could reduce the risk of patients with incontinence developing mental health problems and ensure that any existing mental health problems in these patients are assessed and treated. Ultimately, our research could improve the lives of people affected by incontinence and help the NHS make better use of its resources.