Paruresis is officially recognised and classified as a form of social anxiety disorder. It’s the inability to start or sustain urination when others are present or interruption is likely. The fear is of being scrutinised by real or imaginary “others”. But, just how prevalent is paruresis on a global basis? And just what is the impact of shy bladder syndrome on lives?
It affects both men and women but is more commonly associated with men. It’s a somewhat embarrassing condition that is little talked about or discussed and is still stigmatised to a certain degree. It is however far more common than you might first think.
The Origin Of Paruresis
The condition of shy bladder syndrome as we know it to be today was first cited in a report published in the Journal of General Psychology. This was entitled: Paruresis: a survey of a disorder of micturition and was written by Williams and Degenhardt in 1954. It was this report that defined it as “faulty or disordered micturition (urination)”.
The authors conducted the first formal investigation into the condition and established that around 14% of college students indicated having difficulty urinating in the presence of others and were said to have paruresis. 14% is a huge number though and one to be questioned we feel!
Since this initial report there have only been limited number of further studies. None of these seem to agree with this initial estimate and differ in range significantly. In 1975 Rees and Leach reported an estimate of 25%. This was as a result of studies based solely in North America. Later on, in 1985 Malouff and Lanyon concluded an estimate of 6.8% to be accurate. Later still, in 2005 a study among a sample of German males conducted by Hammelstein, Pietrowsky, Merbach, & Braehler disputed previous findings. They suggested a much more conservative prevalence rate of just 2.8%.
The Prevalence And Impact Of Shy Bladder Syndrome Based On Latest Research
When I’ve searched for the latest estimate as to the number of Paruretics worldwide the number most commonly quoted is around 7%. Indeed, this is the number that the International Paruresis Association (IPA) themselves state. “Paruresis affects about 7% of the population: 20 million people in the U.S., another 2 million in Canada, and countless other people worldwide”.
To be honest, I’m not certain where this estimate of around 7% comes from and I’m not even sure whether it is a proven, accurate figure. I’m assuming that the 1985 report by John Michael Malouff and Richard I.Lanyon is the one likely to be the most accurate. As stated above, the findings of this report suggest the prevalence of Shy Bladder Syndrome to be 6.8%. Whilst this estimate was based on a double screening it did only start with 381 college males. So perhaps the diversity of this particular study may not be good enough to base global estimates on?
Australian research is far more vague. The Australian Journal of General Practice suggests that shy bladder syndrome affects somewhere between 2.8% and 16.4% of the population.
In my experience 7% feels about right but I do think it’s perhaps time for a new, conclusive and global study?
Recent Paruresis Research
There have been other related surveys, studies and research into the condition. The IPA quote results of a survey by the Australian based Global Internet Paruresis Survey which was conducted back in 2004.
This particular survey however was to examine the demographics of 264 adult paruretic males in the age bracket 18 – 80 diversely spread over 20 countries and the impact on their lives. The main finding of this study suggested that: “Over half those surveyed were unable to urinate successfully at public urinals, avoided public toilets, and believed paruresis affected the personal, social, or employment aspects of their lives.”
The other main studies in the 21st century have been as follows:
- The Paruresis Checklist (PCL; Soifer, Zgourides, Himle & Pickering, 2001).
- The Paruresis Scale (Hammelstein, Pietrowsky, Merbach, & Braehler, 2005).
- The Bashful Bladder Scale (Soifer et al., 2010)
- The Shy Bladder Scale (Deacon et al., 2012).
Each of the above however is associated with the assessment of the condition and severity of shy bladder syndrome rather than the accurate estimate of worldwide prevalence.
The Potential Impact Of Shy Bladder Syndrome
As with any social anxiety disorder the impact paruresis can have on lives is varied and substantial. There appear to be no specific proven data into the impact of shy bladder syndrome but there are official estimates:
The International Paruresis Association estimate that potentially thousands of sufferers have lost their jobs due to work related mandatory urine based drugs testing. The findings from a study by Vythilingum et al concluded the following:
- 38.1% of paruretics limited or avoided travel.
- 33.5% avoided parties, public / social events and dating.
- 15.9% reduced or avoided drinking fluids.
- 50.8% reportedly turned down job offers.
- 55.6% limit their occupation.
I should point out that this study involved only a small number (63) of participants.
Then there’s the knock on effect of the condition. It’s estimated that over 20% of paruretics experience major depressive episodes and a high percentage also report alcohol abuse or dependence.
The Prevalence Of Shy Bladder Syndrome – My Conclusion
Paruresis has now been widely recognised as an official condition and is catered for in many situations. Historical studies into the worldwide prevalence of the condition have reported significant differences. A global estimate of around 7% is most commonly quoted but appears without true substance.
I suggest that there’s room for new studies into the worldwide prevalence, recognition and impact on lives of Paruresis shy bladder syndrome. I would therefore urge the powers that be to facilitate this.
Let me introduce a couple of self-help programs that worked for me: