Urinary incontinence and psychological distress among parents of children with spina bifida

Abstract

Objective To evaluate the impact of demographic parameters, urinary system symptoms in children with spina bifida on their parents' anxiety and depression. Methods This prospective clinical trial included children with spina bifida and their primary caregivers. Demographic data, upper urinary tract (UUT) findings, and parental anxiety and depression were recorded between October and December 2024. UUT damage was defined as the presence of renal scarring, hydronephrosis, or vesicoureteral reflux. Caregivers completed the Hospital Anxiety and Depression (HAD) Scale and BECK Anxiety Inventory, with scores categorized into mild, moderate, and severe. Children and parents were stratified into subgroups based on demographics, anxiety and depression levels, UUT damage, febrile urinary tract infection history, incontinence, and motor deficits, and subgroup comparisons were performed. Results A total of 64 children (25 [39.1%] boys, 39 [60.9%] girls) with a median age of 7.5 years and their primary caregivers were evaluated. Median HAD anxiety, HAD depression, and Beck Anxiety scores did not differ significantly according to gender, number of siblings, parental or child age, or parental and child educational levels. In the categorical analyses of anxiety and depression scores, younger parental age (<35 years) was significantly associated with higher anxiety levels across both anxiety assessment scales (HADS-A, p = 0.032Beck Anxiety, p = 0.042). Among clinical parameters, urinary incontinence was linked to higher anxiety and depression scores (respectively, p < 0.045, p < 0.005). Conclusion These findings suggest that certain parental and clinical factors, particularly younger parental age and the presence of urinary incontinence in children with spina bifida, may be associated with increased anxiety and depression levels among caregivers.