Quality of life is defined by the World Health Organization as “an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns”. Having a urological condition may concern the person experiencing it and can also make him vary his daily life.
We aimed to find if there is a link between psychological/psychiatric conditions and benign prostatic disorders.

Study design: Multicentric, prospective, observational study of 558 men over 49 years old who were referred to the Urology department by their general practitioner (GP). 
Both prostatic and psychological check-up were done, and the disorders were categorised as follows:
-	Main urological condition (MUC): urological condition that mainly affects patient’s quality of life.
-	Secondary urological condition (SUC): other urological conditions diagnosed.
-	Main psychological condition (MPC): psychological/psychiatric condition that mainly affects patient’s quality of life.
-	Secondary psychological condition (SPC): other psychological/psychiatric condition diagnosed.

Study groups:
- GA (n=206): men who first attended the GP for a MPC.
- GB (n=352): men who first attended the GP for a MUC.

Variables: Age, body mass index (BMI), time since MPC/MUC diagnosis, time between MPC and MUC, "cured" or "not cured", comorbidities; for MPC, secondary psychological/psychiatric conditions (SPC); for MUC, secondary urological conditions (SUC).

Mean age was 63.30 years, (SD 8.13, range 49-94), no differences were found between GA and GB. 
The urological conditions identified were: non-bacterial prostatitis, acute bacterial prostatitis (ABP), other urinary tract infections (UTI), PIN and prostatodynia (no patient was diagnosed or was suspicious of having a prostate cancer). Table 1 shows the psychological/psychiatric conditions studied in the sample. All men had at least one MUC (with similar distribution between groups), but not all did have a MPC.

Mean time since MPC 93.43 months, SD 78.62, greater in GA than in GB.
Mean time since MUC 40,37 months, SD 42.90, greater in GB than in GA.
Mean time between MPC and MUC 72.52 months, SD 74.49, greater in GA than in GB.

SPC: more common anxiety, psychosis and no psychological disorder in GB; more depression, insomnia, smoking habit and alcohol abuse in GA.

Most frequent urological conditions in both cured or not cured MPC patients: prostatitis, UTI.
Most frequent urological condition in not-cured MUC patients: ABP.
Most frequent urological conditions in cured MUC: PIN and UTI (Figure 1).

Most frequent not-cured MPC: smoking, depression, insomnia.
Most frequent cured MPC: anxiety, psychosis.
MPC more linked to MUC (cured or not): alcohol abuse (Figure 1).

Benign urological conditions can have a negative impact in men’s quality of life, especially anxiety. Some authors have explored the possibility of treating chronic pain syndromes with antidepressants (1), although a recent Cochrane systematic review found that that antidepressants may be ineffective for the reduction of prostatitis symptoms (low- to very low-quality evidence) (2).
Alcohol abuse is also frequent between patients with benign urological conditions, but also in those patients with an impaired psychological background with a tendency of not being cured in the long term. Longitudinal MRI studies of alcoholics have found that following about 1 month of abstinence from alcohol, cortical gray matter, overall brain tissue, and hippocampal tissue increase in volume; these changes may be reverted with abstinence (3). However, the role of anhedonia in alcohol protracted withdrawal syndrome makes it difficult to change habits or having the strength to resolve other health’s problems.

Psychological conditions are frequent in patients with benign prostatic conditions, being alcohol abuse the most frequent one, both in cured (UTI or PIN) and not cured (prostatitis) urological patients.

Turkington D, Grant JB, Ferrier IN, Rao NS, Linsley KR, Young AH. A randomized controlled trial of fluvoxamine in prostatodynia, a male somatoform pain disorder.J Clin Psychiatry. 2002 Sep;63(9):778-81. doi: 10.4088/jcp.v63n0905.
Franco JVA, Turk T, Jung JH, Xiao YT, Iakhno S, Tirapegui FI, Garrote V, Vietto V. Pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome: a Cochrane systematic review. BJU Int. 2020 Apr;125(4):490-496. doi: 10.1111/bju.14988. Epub 2020 Jan 19.
Edith V. Sullivan, R. Adron Harris, Adolf Pfefferbaum. Alcohol’s Effects on Brain and Behavior. Alcohol Res Health. 2010; 33(1-2): 127–143.