Research Frontiers The mental health problems of urolithiasis patients cannot be ignored

A total of 15 randomized studies, 16 non-randomized/quasi-experimental design studies, and 18 observational studies published between 1990 and 2022 were included, of which 46 studies assessed psychological distress with self-reported questionnaires, and three were diagnosed
by clinicians as defined by anxiety and depression as defined by ICD-9-CM or 10th edition (ICD-10).

Figure 1 Research screening flowchart

Psychological distress and urolithiasis

Overall studies have found that people with urolithiasis experience a higher
proportion of psychological distress compared to people with non-urolithiasis.
Two large cohort studies showed that the risk of anxiety increased to 50% and depression increased to 26%
in patients with urolithiasis over a 10-year follow-up.
Other studies have shown that patients with primary or secondary depression or moderate to severe depression are more likely to have urolithiasis
than controls.

Psychological distress and urological treatment

Studies have found that state anxiety scores and stone size prior to shock wave lithotripsy (SWL) treatment are associated with
recovery after SWL.

In addition, studies have also found that patients have a higher risk of anxiety after SWL compared with ureteroscopy (URS) or percutaneous nephroscopic lithotripsy (PCNL) (P<0.
001), and patients have a higher<b20> risk of depression after PCNL compared with URS or SWL.
Therefore, urology-related treatments may also cause psychological distress
in patients.

Psychological distress and waiting to watch

Only one study looked at the association between psychological distress and wait-and-see in people with urolithiasis, and the study found that state anxiety was higher at the end of the waiting period, and this trend was more pronounced
in men.

Proportion of patients with psychological distress

Due to the heterogeneity of the methods used to assess psychological distress among different studies, the researchers conducted narrative studies on it (results are shown in the table).

One study assessed the difference in the incidence of psychological distress between people with urolithiasis and the general population, with 0% and 12.
5% of people with urolithiasis and 12.
5% of normal people with low anxiety and 18.
8% and 3.
1%
of people with severe anxiety, respectively.

Table 1 Proportion of patients who are troubled by research center

Meta-analysis

Seven selected studies were meta-analysed with a total of 626 patients, all assessed
using the State-Trait Anxiety Scale.
Results from meta-analyses showed a moderate association between urolithiasis and state anxiety (pooled r=0.
35, 95% CI 0.
22 to 0.
47).

Fig.
2 Meta-analysis of urolithiasis and anxiety