Submitted by Renata Lopes (renatasil82@gmail.com) on 2018-04-26T14:33:14Z No. of bitstreams: 1 angelamariacorreagoncalves.pdf: 4370650 bytes, checksum: 24ade33c303eec8b353e06d169ceaa6b (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-08-31T12:22:29Z (GMT) No. of bitstreams: 1 angelamariacorreagoncalves.pdf: 4370650 bytes, checksum: 24ade33c303eec8b353e06d169ceaa6b (MD5) / Made available in DSpace on 2018-08-31T12:22:29Z (GMT). No. of bitstreams: 1 angelamariacorreagoncalves.pdf: 4370650 bytes, checksum: 24ade33c303eec8b353e06d169ceaa6b (MD5) Previous issue date: 2018-03-15 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais / Introdução: A depressão clínica é um dos principais problemas de saúde pública na atualidade. No Brasil, segundo o Ministério da Saúde, são mais de 10 milhões de pessoas que sofrem com depressão. A incidência maior da doença se dá entre os 20 e os 40 anos, justamente no auge da vida profissional. As mulheres são as mais vulneráveis ao problema, sendo que o número de casos é o dobro dos homens. Objetivo: Avaliar a prevalência de depressão e os fatores associados em mulheres de 20 a 59 anos de áreas cobertas pela Estratégia de Saúde da Família de município da Zona da Mata Mineira; analisar a experiência de adoecimento de mulheres de 20 a 59 anos atendidas na atenção primária, avaliadas com depressão segundo o PHQ-9. Métodos: Trata-se de um estudo transversal, com mulheres de 20 a 59 anos, cadastradas em duas Unidades de Saúde da Família, que utilizou um questionário contendo variáveis sociodemográficas, apoio social, autoavaliação de estado de saúde, estilo de vida, morbidade e saúde da mulher. O desfecho depressão foi avaliado segundo o PHQ-9, considerando como positivas as mulheres que obtiveram um score ≥ 10 pontos. Para a análise dos fatores associados, foram calculadas as razões de prevalência brutas e ajustadas, por meio de regressão robusta de Poisson. Para a análise da experiência de adoecimento, as mulheres que pontuaram positivamente no PHQ-9 passaram por uma entrevista com médicos psiquiatras que utilizaram como instrumento o CIS-R (Clinical Interview Schedule - Revised), instrumento que tem sido utilizado como padrão de referência em estudos de transtornos mentais comuns. Foram então identificadas mulheres com diagnóstico positivo para depressão e outras em que o afeto de tristeza estava presente, mas que não caracterizavam depressão clinica. Para o conjunto destas mulheres, foi aplicado o questionário McGillIllness Narrative Interview (MINI) e realizada análise de conteúdo deste material. Resultados: Das 1.958 mulheres incluídas nesta análise, 28,5% encontravam-se na faixa etária entre 30 e 39 anos; 15,4% não haviam concluído o ensino elementar; 54,5% não trabalhavam ou nunca trabalharam; e 44,2% declararam não ser da raça branca. A prevalência de depressão encontrada foi de 19,7%, e os fatores associados foram: possuir baixa escolaridade, trabalhar atualmente e ter doença mental prévia. Os fatores associados à ocorrência de depressão na população estudada foram: possuir baixa escolaridade, trabalhar atualmente e ter doença mental prévia. Como fatores de proteção, observaram-se: ser casada ou viver com companheiro, realizar atividades físicas regularmente e relatar autoavaliação positiva de saúde. A análise qualitativa revelou que as mulheres com depressão se tornam descuidadas de seus compromissos devido a um sentimento de incapacidade, prostração, desmotivação, que não lhes permite sair da inércia e assumir a rotina da vida cotidiana. A morte aparece, para algumas, como um alívio e única solução possível para o término do sofrimento. A espiritualidade e a religiosidade contribuíram para amenizar o sofrimento, sendo importantes para a mudança de vida e para a reabilitação. 14 Conclusão: Os resultados revelam que uma assistência específica na atenção primária à saúde deve ser dada às mulheres, especialmente àquelas com baixa escolaridade, que trabalham, apresentam doença mental e não praticam exercícios físicos, a fim de reduzir o sofrimento e promover a saúde. Foi também evidenciado que a falta de sentido na vida torna-se algo aparentemente normal, a ponto de não motivar a procura de ajuda para tratar a doença. Ressalta-se a lacuna na utilização de instrumentos de rastreamento dos casos de depressão na atenção primária. É preciso que os profissionais sejam capacitados para diagnosticar corretamente os transtornos mentais, visando especialmente discriminar depressão e tristeza, evitando a medicalização e a estigmatização. É importante fortalecer a rede assistencial, reconhecendo a necessidade de articular, de forma incisiva, a atenção primária à saúde e as políticas/ações específicas da área da saúde mental. / Introduction: Clinical depression is one of the major public health problems facing our society today. According to the Ministry of Health, there are more than 10 million people suffering from depression in Brazil. Incidence rates were higher among people aged 20 to 40 years old, just at the peak of professional career. Women are the most vulnerable and the number of cases is twice as high as compared to men. Objective: to evaluate the prevalence of depression and associated factors among women aged 20 to 59 years including areas covered by Family Health Strategy at a city in Zona da Mata Mineira; to analyse the illness experience among women aged 20 to 59 assisted in primary care and evaluated with depression according to PHQ-9. Methods: A cross-sectional study with women aged 20 to 59 enrolled in two Family Health Units, using a questionnaire containing sociodemographic variables, social support, self-reported health status, lifestyle, morbidity and women's health. The depression diagnosis was assessed according to the PHQ-9, considering as positive women scoring ≥ 10 points. In order to analyse the associated factors, crude and adjusted prevalence ratios were calculated using robust Poisson regression. To analyze illness experience, women who scored positively on PHQ-9 were interviewed by psychiatrists using the CIS-R (Revised Clinical Interview Schedule), an instrument which has been used as a reference standard in studies of common mental disorders. Women with a positive diagnosis for depression were identified and there were others with symptoms of sadness, but were not diagnosed with clinical depression. For this group of women McGill Illness Narrative Interview questionnaire (MINI) was applied and content analysis of the material was performed. Results: Considering 1,958 women included in this analysis, 28.5% were aged 30 to 39 years; 15.4% had not finished elementary school; 54.5% were not employed or have never worked and 44.2% declared themselves not White. The prevalence of depression was 19.7% and the associated factors were: low level of education, currently employed, and with previous diagnosis of mental disorder. The factors associated with the depression in the investigated population were: low level of education, currently employed and with previous diagnosis of mental disorder. Among the protection factors, there are: be married or live with a partner, perform physical activities regularly and report positive health self-assessment. Qualitative analysis revealed that women with depression do not pay much attention to her appointments due to a sense of inability, prostration, demotivation which prevents her from overcoming inertia and take on daily routine. Death is seen as a relief and the only possible solution to end suffering. Spirituality and religiosity have played a crucial role in order to relieve suffering, being important factors to promote a change in life and rehabilitation. Conclusion: The outcomes have shown that a specific assistance in primary health care should be delivered to women, especially to those with low levels of education, those who are employed and do not practice exercise, in order to reduce suffering and promote health. It was also highlighted that lack of meaning in life appears normal to the extent that it prevents women from searching treatment for the disease. There is a clear gap in the use of screening instruments for cases of depression in primary care. Health professionals must be trained so they may correctly make the diagnosis of mental disorders, especially to distinguish depression and sadness, avoiding medicalization and stigmatization. It is crucial to improve healthcare network, recognizing how important it is to sharply articulate primary health care and specific policies/actions directed to mental health field

En plus de ce qu’il avait écrit auparavant sur la libido dans le Traité du libre arbitre, Augustin a consacré deux passages de la Cité de Dieu à la question de l’affectivité. Dans ces deux textes, qu’on trouve aux livres IX et XIV, il s’affronte aux théories stoïciennes et platoniciennes et s’efforce de montrer la particularité de la conception chrétienne de l’affectivité, en liant les affects à la volonté ; ainsi réintégrés dans l’ordo amoris qui structure l’univers augustinien, les affects sont bons si l’amour qui les motive est orienté vers le bien véritable. Toutefois, dans ces textes, Augustin ne détaille pas ce que sont les affects : il n’en définit aucun, il n’analyse pas les relations qu’on peut établir entre eux. Pourtant, si l’on envisage l’ensemble de son œuvre, on découvre des descriptions variées d’affects nombreux. Ce travail cherche à rendre compte de l’affectivité augustinienne. Il découvre la structure essentielle qui la supporte, qui n’est pas l’ordonnancement de la volonté au bien, mais d’abord l’espérance d’atteindre lavie heureuse. Cette espérance éloigne tout à fait la pensée d’Augustin de celle des philosophes stoïciens ou néoplatoniciens. Elle permet de penser l’affectivité dans sa relation au langage, de comprendre que les affects sont portés par la voix, le souffle, le rire ou les larmes, et comment ils forment eux-mêmes un langage, qui raconte le cheminement (peregrinatio) vers la vie heureuse. / First in De libero arbitrio, then in De ciuitate Dei, Augustine describes his theory of affectivity. In books IX and XIV of De ciuitate Dei, he objects to the Stoician theory of apatheia and the Platonician dualism. He points out the Christian idea of affectivity, which considers the affects depending on the will. In this way, emotions are parts of the Augustinian ordo amoris. They are good if they reveal a true love of the good. In these texts however Augustine does not explain what kind of emotions heis thinking about. He gives no definition of them and does not analyse their interconnections. But in the rest of his writings, we can find various descriptions of several emotions. In this work we try to appreciate Augutine’s affectivity, by understanding that it is not predicated on the good will, but on the hope in the beata uita. This hope makes the thought of Augustin different from Stoician or Neoplatonician philosophy. From this point of view, we can understand how affectivity is linked tolanguage, how emotions are embodied by the voice, the respiration, the laughter and the tears, and how they are also a langage, which tells us the peregrinatio to the uita beata.

The thesis works with Czech translation of apofthegmats - stories of fathers of desert. The thesis focuses on topic of sadness, anger and acedia. The thesis is based on apofthegmats and on the spirituality of desert. From this point of view the thesis makes analysis of the structure of pastoral work with sadness, anger and acedia. The thesis is following some actual authors who are working with spirituality of desert, too. Due to immanent dimension of spirituality of desert the thesis is reflecting psychological approach and refers to actual psychological methods which help a man to live with sadness, anger and acedia.

No description available.

本研究は，これまで1つのネガティブな感情として考えられてきた悲しみ感情にも，種類が存在するのではないかと考え，主観・生理的側面から多角的に検討したものである。3つの研究から，悲しみの中にも，死別のようなあるものを失う悲しみと，失敗のような手に入らなかった悲しみは，それぞれ主観的な特徴，生理的な特徴が異なることが示された。よって，悲しみという感情の中にも種類が存在することが示唆された。 / 博士(心理学) / Doctor of Philosophy in Psychology / 同志社大学 / Doshisha University

The aim of this study was to review six professionals supporters work to support adolescents in grief, and if this support is the kind of support adolescents actually need. These professional supporters are two hospital social workers, two hospice social workers and two support group leaders. The questions included in the work are; How does the professional support look like for adolescents aged 12-18, who has lost a parent in cancer? Are the adolescents getting the support they need from these professionals? The study is based on qualitative interviews based on interview guides, which where then analyzed thematically and linked to previous research and grief theory. The result indicate that adolescents may need different forms of support when their parent is dying or has died. These types of social support can be; to get information about the illness, information about what sorrow is, and at the same time, to be involved in the processes of the parents illness. Furthermore, that there is an open communication with the parent in the family about the incident. This is so that the adolescents should feel that it can open up the thoughts and feelings and feel supported by the parents, and feeling involved in what happens. Many adolescents have a difficulty in talking about emotions and thoughts in grief, and then it is important that they can be talking about them so that they can move on in the sadness processing. This can also adolescents feel that it needs thru the other social network such as relatives and friends. These various forms of social support was offered to the adolescents by the professionals. However, the result indicate that they are not so receptive in getting this support. It may depend on how much time the adolescents have to prepare themselves that the parent will die. There was generally less time for this in the hospital, but more on hospice. At most, they where receptive in support groups, where they could share their experience among like-minded adolescents. Some adolescents where also less receptive for support because of the difficulty to express their emotion and thoughts or because that they where not ready yet to grief, when the support was offered to them by professionals.

Le deuil normal, ou résilient, a souvent été laissé pour compte dans la littérature, au profit de l’intérêt plus grand porté au deuil pathologique. Cette réalité, qui s’inscrit dans le cadre d’une culture de médicalisation, a pu contribuer à la normalisation de la vision du deuil comme nuisible au fonctionnement et inutilement souffrant. Or, un certain regain d’intérêt pour l’étude des processus du deuil normal est visible dans la littérature, l’idée que le deuil résilient est en fait plus répandu que les deuils plus difficiles n’ayant été que récemment démontrée empiriquement (Bonanno, 2009). Une confusion demeure quant au rôle des émotions liées au deuil, qui sont souvent vues comme des symptômes, étant mal différenciées les unes des autres dans leur nature et leur fonction. Pourtant, la tristesse, apanage d’un deuil résilient et sain, aurait une fonction adaptative, contrairement à la détresse et la dépression, qui évoquent davantage le processus de séparation entre l’enfant et sa figure d’attachement. En effet, l’enfant, lors du départ de la figure d’attachement, vit une émotion débordante et intolérable, la protestation, suivie d’un état de désespoir. Ces émotions seraient ainsi qualitativement différentes, et non seulement quantitativement différentes. Cette thèse vise donc d’une part, via un volet théorique, à proposer un modèle du deuil résilient, mais aussi du deuil pathologique, en lien avec la tristesse, la détresse et la dépression, redonnant à chacune leur juste place. Ces deux types de deuil sont présentés comme les extrêmes d’un continuum entre lesquels toute variation peut exister. La tristesse, dans ce modèle, est dépeinte comme une émotion utile, jouant un rôle dans l’acceptation de la perte et dans la capacité à lui donner un sens. D’autre part, un volet empirique s’intéresse à l’expérience subjective de la tristesse chez des endeuillés résilients adultes ayant perdu un parent. Des entrevues semi-structurées ont été conduites auprès de six participants, et les résultats ont été analysés avec une approche qualitative, l’Analyse Phénoménologique Interprétative (IPA). Les résultats montrent que la tristesse était vécue comme étant tolérable, comme ayant une fonction adaptative et un sens, même si elle reste désagréable à vivre. Comme le deuil n’est pas vécu en vase clos, un surplus de matériel à métaboliser et des circonstances externes variables, ainsi que des variations dans les capacités de mentalisation, peuvent expliquer la présence d’autres expériences émotionnelles et de symptômes somatiques. La tristesse semble toutefois être un ingrédient essentiel d’un deuil résilient, où la personne demeure fonctionnelle et n’est triste que par courtes périodes, venant par vagues. Les implications cliniques et diagnostiques de ces résultats ainsi que du modèle présenté dans cette thèse sont abordées. / Normal, or resilient, grief has often been neglected in the literature, overshadowed by the greater number of studies on pathological grief. This fact, congruent with the trend towards a culture of medicalization, can explain the normalization of the idea of grief as uselessly painful, or even harmful, a nuisance to productivity and functioning. On the other hand, there has been a growing interest in the processes of normal grief in recent years, the idea that resilient grief is more common than pathological grief having only been recently supported by empirical research (Bonanno, 2009). However, the function and nature of grief-related emotions, which are often seen as symptoms, still isn’t clear. Sadness, contrarily to common knowledge, seems to be a healthy characteristic of resilient grief, and could have an adaptive function, whereas distress and depression would evoke the protest and despair phases of the separation between the child and her attachment figure. Thus, these three affective experiences would be qualitatively, and not only quantitatively, distinct. This thesis aims to present, in its first part, a theoretical model of both resilient and pathological grief, elaborating on the function and place of sadness, distress and depression. These two types of grief are presented as the extremes of a continuum, in between which any number of variations could exist. Sadness, in this model, is depicted as a useful emotion that plays a part in the acceptation of loss and in the creation of a meaning. In its second, empirical part, the subjective experience of sadness in resilient grieving adults who lost a parent is observed. Semi-structured interviews were conducted with six participants, and the results were analyzed using Interpretative Phenomenological Analysis (IPA). Results show that sadness was experienced as tolerable, adaptive, and making sense, even if it was painful. As grief is never an isolated experience in life, circumstances and concurrent events, and variations in mentalization abilities, can explain the presence of other emotions or of somatic symptoms. Sadness, however, seems to be an essential ingredient of resilient grief, where the person remains functional, but is sad only by shorts bursts, coming in waves. The clinical and diagnostic implications of these results and of the theoretical model presented in this thesis are discussed.

La représentation que se font les patients souffrant d’un trouble de personnalité limite (TPL) de leur expérience de tristesse est un domaine de recherche important tant pour la conceptualisation du trouble que pour son traitement. Ces patients sont connus pour vivre une grande détresse qui se manifeste à travers divers symptômes (Bland, Williams, Scharer, & Manning, 2004). Un nombre élevé de patients présentant un TPL se suicident (Paris, 2002), font au moins une tentative de suicide au cours de leur vie (Oldham, 2006) et s’automutilent (p.ex., Brown, Williams, & Collins, 2007). La recherche sur la souffrance du TPL s’entend sur un paradoxe : ces patients souffrent beaucoup, mais ils vivent peu de tristesse. Leur souffrance prend une forme distincte en qualité, celle-ci demandant à être davantage étudiée empiriquement et théoriquement. L’objectif de cette thèse est d’explorer la représentation de la tristesse de participants souffrant d’un TPL. Alors qu’à notre connaissance aucune étude n’a encore poursuivi cet objectif spécifique, différentes pistes de réflexion ont été soulevées dans la documentation scientifique pour expliquer la nature de la souffrance du TPL en ce qui a trait au tempérament, au fonctionnement mental, à la dépression, à l’organisation de la personnalité et aux événements traumatiques. La première étude de cette thèse vise à réfléchir théoriquement et cliniquement à la tristesse, afin d’en raffiner la définition, entre autres par opposition à la détresse. Elle propose une distinction tant au plan métapsychologique que phénoménologique de ces deux expériences, en se basant sur des théories évolutionnistes des émotions et sur différentes conceptions psychanalytiques du fonctionnement mental et des relations objectales. Une vignette clinique illustre cette réflexion. La seconde étude vise à explorer, par une démarche qualitative, les principaux thèmes abordés par des participants souffrant d’un TPL lorsqu’ils racontent des épisodes de tristesse. Sept participants avec un diagnostic de TPL évalué à l’aide du SCID-II (First, Gibbon, Spitzer, & Williams, 1997) ont participé à une entrevue semi-dirigée visant le rappel de deux épisodes relationnels de tristesse. Suivant la méthode d’analyse phénoménologique interprétative (Smith, 1996), une analyse thématique de quatorze épisodes de tristesse a été effectuée conjointement par deux candidates au doctorat pour décrire la représentation de la tristesse de ces participants. Cinq thèmes ont été identifiés : 1) agression, 2) relation brisée par l’autre, 3) affectivité négative indifférenciée, 4) soi défectueux et 5) débordement. Les résultats suggèrent que la représentation de la tristesse du TPL n’est pas associée à la perte, mais plutôt à l’impression d’avoir été endommagé par une attaque infligée par quelqu’un d’autre. Il s’agit d’une expérience peu mentalisée que l’individu semble tenter de réguler dans la sphère interpersonnelle. Cette expérience ne représenterait pas de la tristesse à proprement parler. Les conclusions ont permis d’élaborer une nouvelle hypothèse de recherche : l’expérience de tristesse des patients souffrant d’un TPL ne correspond pas à la tristesse proprement dite, mais à une forme de détresse interpersonnelle impliquant à la fois des déficits du fonctionnement mental et une organisation particulière de la personnalité. Les implications cliniques et théoriques sont discutées. / The exploration of the phenomenology of sadness in patients with Borderline Personality Disorder (BPD) is relevant to the understanding of the pathology and to its treatment. BPD patients tend to experience distress intensely and frequently, and inefficient attempts at regulating this emotional experience is known to be associated with symptoms, such as suicidal or parasuicidal gestures (Bland, Williams, Scharer, & Manning, 2004; Brown, Williams, & Collins, 2007; Oldham, 2006; Paris, 2002). The literature on psychological suffering in BPD reveals an apparent contradiction: these patients experience a large amount of suffering, but they appear to not experience sadness. The nature of their suffering seems to be distinct from sadness, and has yet to be more fully explored empirically and theoretically. The present thesis aims at exploring the phenomenology of sadness in BPD. To our knowledge, no research has specifically attempted to investigate this particular topic, but some etiological pathways for understanding BPD suffering have been explored: temperament, mental functioning, depression, personality organization and traumatic events. The first study proposes a theoretical and clinical investigation of the concept of sadness and defines it in opposition to distress. This distinction between sadness and distress focuses on phenomenological and metapsychological perspectives, and is in line with evolutionary theories of emotion and psychoanalytic formulations on mental functioning and object relationships. A case study illustrates this investigation. The second study aims at exploring the phenomenology of sadness through an investigation of the major themes that BPD participants talk about when they are asked to recall episodes of sadness. Seven individuals with a diagnosis of BPD on the SCID-II (First, Gibbon, Spitzer, & Williams, 1997) participated in a semi-structured interview. Following the Interpretative Phenomenological Analysis principles (Smith, 1996), a thematic analysis of 14 transcripts was performed by two doctoral students in order to outline the representation of sadness of BPD participants. Five themes were found: 1) aggression, 2) relationship broken off by the other, 3) undifferentiated negative affect, 4) self being defective, and 5) overwhelming experience. The results suggest that ‘sadness’ in those episodes is not associated with a representation of loss, but with a state of being ‘damaged’ by the aggression and/or the breaking off of the relationship inflicted by the other. This is a non-mentalized experience that the participants tend to regulate in the interpersonal field. This experience should not be conceptualized as sadness proper. In conclusion, a new hypothesis emerges: the experience of sadness for BPD patients is not really sadness, but a form of interpersonally-focused distress. This emotional experience is characterized by a deficit in mental functioning and by a particular personality organization. Clinical and theoretical implications are discussed.

<p>The aim the thesis was to investigate, the prevalence of Lower Urinary Tract Symptoms (LUTS). Moreover, we examine symptom severity and different levels of distress and describe how different symptoms from the lower urinary tract affect the self-assessed health, sadness, happiness and the quality of life in men. </p><p>The studies are based on two data collections. In the first data collection, all men aged 40 – 80 years (n=2571) living in the Swedish community received a postal questionnaire. Twelve months later, 504 men who had earlier reported LUTS and 504 who had not reported symptoms were asked to complete the DAN-PSS and the SF-36 questionnaires. </p><p>The overall prevalence of LUTS was 24%. Post-micturition dribbling (21%) was the most frequent symptom, and stress incontinence (2%) was the least frequent symptom. Urge incontinence, stress incontinence and “other” incontinence cause a high level of distress, even if the symptoms do not occur very often. Men experiencing mild, moderate or severe urge, stress or “other incontinence” had lower mean scores for all of the eight dimensions measured by the SF-36 than men without the same symptoms. Men experiencing a moderate/severe degree of weak stream or nocturia reported a poorer quality of life in all dimensions compared to men with a mild level of the same symptoms. The total burden of moderate/severe LUTS is related to self-assessed health, sadness and happiness. For each of the 12 specific LUTS, men with mild, moderate or severe symptoms had lower scores for self-assessed health and happiness, and higher scores for self-assessed sadness, than men without the same symptoms. </p><p>In conclusions, one of every four men reports LUTS. Urinary incontinence causes high level of distress even to men who experience this symptom rarely. LUTS have a negative impact on quality of life, health, sadness and happiness. </p>

The aim the thesis was to investigate, the prevalence of Lower Urinary Tract Symptoms (LUTS). Moreover, we examine symptom severity and different levels of distress and describe how different symptoms from the lower urinary tract affect the self-assessed health, sadness, happiness and the quality of life in men. The studies are based on two data collections. In the first data collection, all men aged 40 – 80 years (n=2571) living in the Swedish community received a postal questionnaire. Twelve months later, 504 men who had earlier reported LUTS and 504 who had not reported symptoms were asked to complete the DAN-PSS and the SF-36 questionnaires. The overall prevalence of LUTS was 24%. Post-micturition dribbling (21%) was the most frequent symptom, and stress incontinence (2%) was the least frequent symptom. Urge incontinence, stress incontinence and “other” incontinence cause a high level of distress, even if the symptoms do not occur very often. Men experiencing mild, moderate or severe urge, stress or “other incontinence” had lower mean scores for all of the eight dimensions measured by the SF-36 than men without the same symptoms. Men experiencing a moderate/severe degree of weak stream or nocturia reported a poorer quality of life in all dimensions compared to men with a mild level of the same symptoms. The total burden of moderate/severe LUTS is related to self-assessed health, sadness and happiness. For each of the 12 specific LUTS, men with mild, moderate or severe symptoms had lower scores for self-assessed health and happiness, and higher scores for self-assessed sadness, than men without the same symptoms. In conclusions, one of every four men reports LUTS. Urinary incontinence causes high level of distress even to men who experience this symptom rarely. LUTS have a negative impact on quality of life, health, sadness and happiness.