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Stress, Hostility, and Disease Parameters of Benign Prostatic Hyperplasia

Ullrich, Philip M. PhD; Lutgendorf, Susan K. PhD; Leserman, Jane PhD; Turesky, Derek G. BA; Kreder, Karl J. MD

Original Articles

Objective: Psychological factors such as stress are known to influence activity in the sympathetic nervous system and hypothalamic–pituitary–gonadal axis, systems that in turn have been implicated in the development of benign prostatic hyperplasia (BPH). Associations between psychological stress and prostate function have not been directly examined. The objective of this study was to examine associations among stress, hostility, and BPH disease parameters.

Methods: Eighty-three men diagnosed with BPH completed self-report and interview measures of stress and hostility followed by measures of urologic function.

Results: Higher lifetime stress was associated with lower prostate volumes and residual urine volumes (p’s < .05). By contrast, high recent stress and hostility were associated with greater residual urine (p’s < .05). Stress and hostility were not associated with self-report ratings of urologic symptoms.

Conclusions: Stress and hostility were associated with objective measures of urologic functioning among men with BPH. Results highlight the need for increased attention in research and clinical settings toward associations between psychological factors and urologic disease.

BPH = benign prostatic hyperplasia; LUTS = lower urinary tract symptoms; SNS = sympathetic nervous system; AUA = American Urological Association; mL = milliliters; ANCOVA = analysis of covariance; HSD = honestly significant difference; SD = standard deviation.

From the Department of Rehabilitation Medicine, University of Washington, Seattle, WA (P.M.U.); the Departments of Psychology and Obstetrics and Gynecology (S.K.L., D.G.T.) and Urology (K.J.K.), University of Iowa, Iowa City, IA; and the Department of Psychiatry, University of North Carolina, Chapel Hill, NC (J.L.).

Address correspondence and reprint requests to Philip M. Ullrich, PhD, Department of Rehabilitation Medicine, box 359740, Harborview Medical Center, 325 Ninth Ave, Seattle, WA 98104. E-mail:

Received for publication September 1, 2004; revision received December 1, 2004.

This study was funded by National Institutes of Health grant DK49971 awarded to the fourth author (K.J.K.).

Copyright © 2005 by American Psychosomatic Society
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