Prevalence of and Factors Associated with Overactive Bladder, Anxiety, and Depression Among Patients with Multiple Sclerosis: A Cross-Sectional Study in Saudi Arabia.

BACKGROUND

Over the years, it has become increasingly clear that neurological conditions, such as multiple sclerosis (MS), commonly exhibit other health problems. Therefore, this is the first study aimed at investigating the prevalence of and factors associated with three binary outcomes: depression, anxiety, and an overactive bladder (OAB) among MS patients in the Qassim region, Saudi Arabia.

METHODS

This cross-sectional study was conducted in the neurological department of King Fahad Specialist Hospital in the Qassim region, Saudi Arabia, from January to December 2024. Data on age, sex, marital status, occupation, body mass index (BMI), MS duration, comorbidities, anxiety, depression, and OAB symptoms (frequency, nocturia, urgency, and urge incontinence) were obtained.

RESULTS

Of the 262 MS patients in this study, 184 (70.2%) were females, and 78 (29.8%) were males. The median values [IQR] of age and MS duration were 34 [26-40] and 5 [2-9] years, respectively. The prevalence of depression, anxiety, and OAB were 53.4%, 43.9%, and 50%, respectively. Nocturia was the most frequent urinary symptom, and urge incontinence was significantly higher among females. Multiple logistic regression analyses were conducted to assess factors associated with three binary outcomes: depression, anxiety, and OAB. For depression, being single and anxiety were associated with increased risk. Regarding anxiety, being a student was related to decreased risk, while being female and having depression were associated with increased risk. For OAB, only anxiety was associated with increased risk.

CONCLUSIONS

Approximately one in two MS patients experience either depression or OAB, while anxiety was reported by fewer than half of the patients. This high prevalence of the three outcomes has critical implications for healthcare policy and resource allocation. Thus, screening, early diagnosis, and intervention, as well as integrated care, should be prioritized by healthcare institutions and practitioners to address these conditions and improve MS patients' quality of life.