Mindfulness-based stress reduction as a novel treatment for interstitial cystitis/bladder pain syndrome: a randomized controlled trial

Abstract

Purpose Mindfulness-based stress reduction (MBSR) is a standardized meditation program that may be an effective therapy for Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS), a condition exacerbated by stress. The aims of this study were to explore 1) whether MBSR improved IC/BPS symptoms 2) MBSR’s feasibility/acceptability among women with IC/BPS. Materials and Methods This randomized controlled trial included women with IC/BPS undergoing 1st-or 2nd line therapies. Women were randomized to continuation of usual care (UC) or an 8-week MBSR class + usual care (MBSR). Participants completed baseline and 8 week post-treatment questionnaires including the O’Leary-Sant Symptom Problem Index (OSPI), visual analog pain scale (VAS), Short Form Health Survey (SF-12), Female Sexual Function Index (FSFI), and Pain Self-Efficacy Questionnaire (PSEQ). The Global Response Assessment (GRA) was completed post-treatment. Analyses were performed using Student’s t-test, Chi-square and MANOVA where appropriate. Results Eleven women randomized to UC and 9 to MBSR, without differences in group characteristics. More MBSR participants’ symptoms were improved on the GRA [7/8(87.5%) vs. 4/11(36.4%), p=0.03]. The MBSR group had greater improvement in OSPI total (p=0.0498) and problem scores (p=0.036); OSPI symptom score change did not differ. PSEQ scores improved in MBSR compared to UC (p=0.035). VAS, SF-12, and FSFI change did not differ between groups. Eighty-six percent of MBSR participants felt more empowered to control symptoms, and all participants planned to continue MBSR. Conclusions This trial provides initial evidence that MBSR is a promising adjunctive therapy for IC/BPS. Its benefit may arise from patients’ empowerment and ability to cope with symptoms.

Important role of physicians in addressing psychological aspects of interstitial cystitis/bladder pain syndrome (IC/BPS): a qualitative analysis

“…They also help to explain why a multimodal approach addressing the psychosocial aspects of chronic pain may be important in treating IC/BPS. In recent work by our group [31], we found that Mindfulness-Based Stress Reduction improved IC/BPS self-efficacy. The impact of this intervention may be explained by its effect on the isolation aspect of the condition, or perhaps from helping to calm patients’ minds to guard against the unpredictable nature of the process.…”

Psychosocial co‐morbidities in Interstitial Cystitis/Bladder Pain syndrome (IC/BPS): A systematic review

“…Although these investigations were all pilot studies and had limited follow‐up, the findings are promising. Those treated reported significant reductions in pain and urinary urgency, had greater perceived control of symptoms, and better healthcare outcomes than controls . The impact of these interventions on psychological states and co‐morbidity has yet to be assessed.…”

Pain-Related Rumination, But Not Magnification or Helplessness, Mediates Race and Sex Differences in Experimental Pain

“…Indeed, these treatments have been shown to improve pain outcomes such as pain intensity, functional limitations, and psychological distress 57,65 , and they have also been found to reduce ruminative thinking associated with depression, cancer, and school-related stress 14,34,44 . Unfortunately, although mindfulness-related treatment effects have been demonstrated in women 8,38,63,68 , only a few studies have examined their effectiveness in Black individuals and none were focused on pain 16,66,82 . The current results suggest that ongoing clinical and research efforts to better understand pain-related rumination and its responsiveness to different treatments might, among other things, mitigate longstanding race and sex disparities in pain.…”