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. 2018 Mar;37(3):926-941.
doi: 10.1002/nau.23421. Epub 2017 Oct 9.

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

Lindsey C McKernan  1   2 , Colin G Walsh  1   3   4 , William S Reynolds  5 , Leslie J Crofford  3 , Roger R Dmochowski  5 , David A Williams  6
Affiliations

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

Lindsey C McKernan et al. Neurourol Urodyn. 2018 Mar.

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.

Keywords: Bladder Pain Syndrome; IC/BPS; Interstitial Cystitis; anxiety; depression; psychosocial; systematic review; trauma.

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Figures

FIGURE 1
FIGURE 1
Flow diagram per PRISMA (2009). Adapted from PLoS Med. 2009;6:e1000097
See this image and copyright information in PMC

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