Urinary incontinence in inpatient psychiatry: prevalence, change and relationship to length of stay

Aims and objectives. To identify the prevalence of urinary incontinence in inpatient psychiatric settings and its relationship to length of stay. Background. Urinary incontinence is a common and disabling condition. Previous work has shown that urinary incontinence is not always considered to be important in inpatient psychiatry. Design. Retrospective analysis of provincial database for inpatient psychiatry. Method. The study included all psychiatric inpatients in Ontario assessed with the Resident Assessment Instrument Mental Health at both admission and discharge since 1 October 2005. We used sex-based analyses to examine the prevalence of urinary incontinence at admission and change over the inpatient stay. Logistic regression was used to determine the relationship between urinary incontinence and experiencing an above average length of stay in hospital. Results. The prevalence of urinary incontinence at admission was 5.6%; rates were higher among women and the profiles of afflicted men and women differed. Approximately 35% of psychiatric patients were no longer incontinent at the time of discharge, and new cases of incontinence were reported for 1.2% of patients. Both the presence of urinary incontinence at admission and development of urinary incontinence over the inpatient stay were related to increased likelihood of having a longer than average length of stay. These odds were significant for both sexes, but higher for women for the role of urinary incontinence at admission and higher for men for the role of developing urinary incontinence. Conclusion. Urinary incontinence was present among a non-trivial proportion of psychiatric inpatients and persisted for most throughout the inpatient stay. Presence of urinary incontinence was related to increased hospital stay. Relevance to clinical practice. Mental health service providers should identify urinary incontinence quickly and pay attention to it; incorporating treatment into the care plan early on in the inpatient stay may help to ensure a more rapid return to the community.