This pain drives me crazy: Psychiatric symptoms in women with interstitial cystitis/bladder pain syndrome

Abstract

Background: Interstitial cystitis/bladder pain syndrome (IC/BPS) is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic, abdominal, and/or pelvic pain. Although the term cystitis suggests an inflammatory or infectious origin, no definite cause has been identified. It occurs in both sexes, but women are twice as much affected.

Aim: To systematically review evidence of psychiatric/psychological changes in persons with IC/BPS.

Methods: Hypothesizing that particular psychological characteristics could underpin IC/BPS, we investigated in three databases the presence of psychiatric symptoms and/or disorders and/or psychological characteristics in patients with IC/BPS using the following strategy: ("interstitial cystitis" OR "bladder pain syndrome") AND ("mood disorder" OR depressive OR antidepressant OR depression OR depressed OR hyperthymic OR mania OR manic OR rapid cycl^asterisk OR dysthymi^asterisk OR dysphori^asterisk).

Results: On September 27, 2023, the PubMed search produced 223 articles, CINAHL 62, and the combined PsycLIT/ PsycARTICLES/PsycINFO/Psychology and Behavioral Sciences Collection search 36. Search on ClinicalTrials.gov produced 14 studies, of which none had available data. Eligible were peer-reviewed articles reporting psychiatric/psychological symptoms in patients with IC/BPS, i.e. 63 articles spanning from 2000 to October 2023. These studies identified depression and anxiety problems in the IC/BPS population, along with sleep problems and the tendency to catastrophizing.

Conclusion: Psychotherapies targeting catastrophizing and life stress emotional awareness and expression reduced perceived pain in women with IC/BPS. Such concepts should be considered when implementing treatments aimed at reducing IC/BPS-related pain.

Keywords: Anxiety; Catastrophizing; Depression; Interstitial cystitis/bladder pain syndrome; Psychiatric symptoms; Psychological symptoms.

Figure 1

PRISMA flowchart of our search and inclusion procedures. ¹Consider, if feasible to do so, reporting the number of records identified from each database or register searched (rather than the total number across all databases/registers); ²If automation tools were used, indicate how many records were excluded by a human and how many were excluded by automation tools; ³No automation tools were used. IC/BPS: Interstitial cystitis/bladder pain syndrome.

Figure 2

Per year distribution of eligible studies.