Premium
Posttraumatic stress disorder in interstitial cystitis/bladder pain syndrome: Relationship to patient phenotype and clinical practice implications
Author(s) -
McKernan Lindsey C.,
Johnson Benjamin N.,
Reynolds William S.,
Williams David A.,
Cheavens Jennifer S.,
Dmochowski Roger R.,
Crofford Leslie J.
Publication year - 2019
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23861
Subject(s) - interstitial cystitis , medicine , chronic pain , distress , sexual abuse , genitourinary system , psychiatry , epidemiology , clinical psychology , urinary system , poison control , injury prevention , emergency medicine
Purpose The relationship between exposure to abuse and interstitial cystitis/bladder pain syndrome (IC/BPS) is well‐documented. However, studies have yet to examine posttraumatic stress disorder (PTSD), which develops following exposure to trauma and worsens health outcomes in chronic pain. We aimed to assess the prevalence and impact of PTSD in patients with IC/BPS, including their relation to genitourinary symptom presentation and widespread pain phenotype. Materials and Methods We recruited 202 participants with chronic pain from an academic medical center and classified 64 individuals as IC/BPS based on validated epidemiological criteria. Participants completed self‐reported questionnaires assessing trauma exposure, PTSD symptoms, emotional distress, pain, and urinary symptoms. Wilcoxon rank‐sum tests assessed study aims comparing IC/BPS to other chronic pain. Results Although elevated, IC/BPS trauma exposure rates were equivalent to that of other chronic pain conditions in the sample. Despite this equivalence, in comparison, IC/BPS patients had significantly higher rates of PTSD symptoms, with 42% meeting provisional diagnostic criteria for PTSD. Among IC/BPS, those meeting provisional criteria for PTSD had significantly higher incidence of lifetime sexual abuse, childhood trauma, and presentations consistent with the widespread pain phenotype. In IC/BPS, there was no association between PTSD and genitourinary symptoms, but provisional PTSD was associated with more pain, emotional distress, and poorer quality of life. Conclusions We recommend that patients with IC/BPS and widespread pain have ongoing screening and monitoring of PTSD. We recommend using trauma‐informed care practices with these patients to increase trust and safety, which could improve treatment compliance and follow‐up.