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

Abstract

Aims Psychosocial factors amplify symptoms of Interstitial Cystitis (IC/BPS). While psychosocial self-management is efficacious in other pain conditions, its impact on an IC/BPS population has rarely been studied. The objective of this review is to learn the prevalence and impact of psychosocial factors on IC/BPS, assess baseline psychosocial characteristics, and offer recommendations for assessment and treatment. Method Following PRISMA guidelines, primary information sources were PubMed including MEDLINE, Embase, CINAHL, and GoogleScholar. Inclusion criteria included: (i) a clearly defined cohort with IC/BPS or with Chronic Pelvic Pain Syndrome provided the IC/BPS cohort was delineated with quantitative results from the main cohort; (ii) all genders and regions; (iii) studies written in English from 1995 to April 14, 2017; (iv) quantitative report of psychosocial factors as outcome measures or at minimum as baseline characteristics. Results Thirty-four of an initial 642 articles were reviewed. Quantitative analyses demonstrate the magnitude of psychosocial difficulties in IC/BPS, which are worse than average on all measures, and fall into areas of clinical concern for 7 out of 10 measures. Meta-analyses shows mean Mental Component Score of the Short-Form 12 Health Survey (MCS) of 40.80 (SD 6.25, N = 2912), where <36 is consistent with severe psychological impairment. Averaged across studies, the population scored in the range seen in clinical depression (CES-D 19.89, SD 13.12, N = 564) and generalized anxiety disorder (HADS-A 8.15, SD 4.85, N = 465). Conclusion The psychological impact of IC/BPS is pervasive and severe. Existing evidence of treatment is lacking and suggests self-management intervention may be helpful.

Normalization of magnesium deficiency attenuated mechanical allodynia, depressive-like behaviors, and memory deficits associated with cyclophosphamide-induced cystitis by inhibiting TNF-α/NF-κB signaling in female rats

“…Population-based studies have shown that the female-to-male ratio ranges from 5:1 [3] to 10:1 [4], and most clinical studies include women only since confounding diagnoses are common in men with chronic prostatitis [5]. Additionally, depression and memory problems often accompany and amplify the symptoms of BPS/IC [6]. A previous study revealed that about one third of these patients have depressive disorders [7].…”

Self‐perception of symptoms, medical help seeking, and self‐help strategies of women with interstitial cystitis/painful bladder syndrome

“…16 Most pain symptoms received appropriate treatment only after at least 6 months 17 and patients visited seven to eight different physicians 18 due to patients' lack of knowledge of their own disease, which creates high psychological pressure. [19][20][21] Patients commonly hope that physicians will provide the aforementioned knowledge about disease management and help them cope with pain [22][23][24] or provide self-management skills.…”

Anxiety severity does not influence treatment outcomes in patients with interstitial cystitis/bladder pain syndrome

“…19 A previous study proposed that psychosocial factors, such as comorbid anxiety, depression, and QoL issues might increase IC/BPS symptoms. 21 However, the study results revealed that satisfactory treatment outcome could significantly lower BAI, particularly in patients with severe baseline anxiety. An unsatisfactory bladder condition after treatment is the primary cause of patient distress.…”

“…Furthermore, the book Bladder Pain Syndrome – An Evolution (2017) states that there are no good or bad treatments, only suitable or unsuitable treatments, emphasizing the need to deliver “the right treatment to the right patient” and that any therapy should focus on the bladder . A previous study proposed that psychosocial factors, such as comorbid anxiety, depression, and QoL issues might increase IC/BPS symptoms . However, the study results revealed that satisfactory treatment outcome could significantly lower BAI, particularly in patients with severe baseline anxiety.…”