It is well known that majority of patients with lower urinary tract symptoms(LUTS) experience symptom flare or aggravation with psychosomatic stress. Besides, chronicity of the disease progression also affects patients’ psychologic health. In this study, we aimed to investigate the psychological characteristics of chronic bladder diseases, OAB and IC/BPS in particular and also aimed to research psychological impact as a background factor for LUTS phenotypes.

It is a retrospective chart review study analyzing patients’ data including medical history, voiding diary, OAB-SS questionnaire, Visual analogue scale(VAS), and psychometric analysis tools designed for LUTS/pain patients of our institution, which is named as Ewha Urologic Pain and Function Index, EUPFI. This EUPFI questionnaires are consisted with several validated psychometric evaluation tools; Beck’s depression inventory(BDI), Beck’s anxiety inventory(BDI), Panic attack index(PAI), Hospital anxiety score(HAS), and Bender-Gestalt test (BGT), etc. EUPFI self- filling up and psychological interview with BGT evaluation were performed by trained clinical psychologists.
Score of each index, BGT interpretation and analysis, patient’s urological data were comprehensively analyzed.

Data of 515 women who have done EUPFI test with LUTS from April 2019 to December 2019 were analyzed. 244 out of 515 (47.4%) patients have diagnosed as OAB and 203 (39.4%) have diagnosed as IC/BPS based on their symptoms. Mean age of the patients was 49 (OAB) and 48 (IC/BPS) years old respectively. Mean VAS, BDI, BAI, PAI are shown in table 1 (p=0.474, t-test). 
Each groups of patients' psychological diagnosis and characteristics are shown in table 2. 66.7 % of IC/BPS  patients and 57.6 % of OAB patients showed psychological feature of depression.

Significant portion of OAB and IC/BPS patients showed variety of psychological problems, depression is most common in both groups, anxiety, obsession, and somatization disorders are also present. In psychometric analysis, depression, panic, and anxiety related indices are increased suggesting the psychological background of LUTS expression and symptom progression.

In this study, we confirmed that psycho-somatic relationship cannot be ruled out in LUTS manifestation and symptom progression. Those psychological problems could co-existing underlying conditions or psychological sequelae from chronic intractable, irritating LUTS to patient’s quality of life. Most common psychological problems in OAB and IC/BPS was depression. Although somatization, anxiety and obsession take relatively small portion in these two groups of patients, those psychological conditions may affect patients' perception of their bladder symptoms. Therefore, adequate combination of urological and pyschological intervention in management of OAB and IC/BPS would provide better clinical success with less recurrence of symptoms.
More attention is required to patient’s psychological status and mental health to manage chronic bladder disease.