Detection and Triage of Urinary Incontinence Problems in a Psychiatric Practice

Urinary incontinence is a common complaint in women, and the incidence increases with age. Since continence is the result of the interaction of several neurologic, anatomic, and physiologic factors, it may be affected by a number of pathological conditions, physical changes, or pharmacologic agents. Psychiatrists are often the only physicians caring for women in an ongoing fashion. But patients are often embarrassed to discuss incontinence unless directly questioned. Thus, it is reasonable for a psychiatrist to ask about this problem, take a history to help determine whether the patient will respond to simple therapy or whether she may require referral. This paper will define the types of incontinence and the etiologic factors that may be the cause and will offer suggestions as to how the psychiatrist can evaluate the patient initially and decide on appropriate disposition of the patient with this problem.