Gynecologists and other primary care physicians have long recognized the occurrence of psychogenic factors in some patients with urinary incontinence, usually of the urgency or detrusor dyssynergia types. However, to the best of our knowledge this is the first report of psychiatric study of these patients. Eighteen patients were referred following complete gynecologic urology work-up including electronic urethrocystometry and chain cystography. Most of these patients were 40 to 60 years of age, were multiparous, and had had hysterectomies. Major psychiatric findings were a) severe situational problems in all 18 patients, b) chronic depression in 17, and c) hysterical personality traits in 10. Patients whose psychiatric treatment provided some relief of their situational and emotional distress also, concomitantly, had relief of urinary incontinence.