Lindsey C McKernan1,2, Benjamin N Johnson3, William S Reynolds4, David A Williams5, Jennifer S Cheavens6, Roger R Dmochowski4, Leslie J Crofford7. 1. Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, Tennessee. 2. Department of Physical Medicine and Rehabilitation, Vanderbilt University School of Medicine, Nashville, Tennessee. 3. Department of Psychology, The Pennsylvania State University, State College, Pennsylvania. 4. Department of Urologic Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee. 5. Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan. 6. Department of Psychology, The Ohio State University, Columbus, Ohio. 7. Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee.
Abstract
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.
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/BPSpatients 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.
Authors: Jennifer H Wortmann; Alexander H Jordan; Frank W Weathers; Patricia A Resick; Katherine A Dondanville; Brittany Hall-Clark; Edna B Foa; Stacey Young-McCaughan; Jeffrey S Yarvis; Elizabeth A Hembree; Jim Mintz; Alan L Peterson; Brett T Litz Journal: Psychol Assess Date: 2016-01-11
Authors: Chad M Brummett; Rishi R Bakshi; Jenna Goesling; Daniel Leung; Stephanie E Moser; Jennifer W Zollars; David A Williams; Daniel J Clauw; Afton L Hassett Journal: Pain Date: 2016-06 Impact factor: 7.926
Authors: Eva Raphael; Stephen K Van Den Eeden; Carolyn J Gibson; Chris Tonner; David H Thom; Leslee Subak; Alison J Huang Journal: Am J Obstet Gynecol Date: 2021-09-20 Impact factor: 8.661
Authors: Paulina Nunez-Badinez; Bianca De Leo; Alexis Laux-Biehlmann; Anja Hoffmann; Thomas M Zollner; Philippa T K Saunders; Ioannis Simitsidellis; Ana Charrua; Francisco Cruz; Raul Gomez; Miguel Angel Tejada; Stephen B McMahon; Laure Lo Re; Florent Barthas; Katy Vincent; Judy Birch; Jane Meijlink; Lone Hummelshoj; Patrick J Sweeney; J Douglas Armstrong; Rolf-Detlef Treede; Jens Nagel Journal: Pain Date: 2021-09-01 Impact factor: 6.961
Authors: Bethany F Laden; Catherine Bresee; Amanda De Hoedt; Kai B Dallas; April Scharfenberg; Roopali Saxena; Justin F Senechal; Kamil E Barbour; Jayoung Kim; Stephen J Freedland; Jennifer T Anger Journal: Urology Date: 2021-04-23 Impact factor: 2.649
Authors: Matty D A Karsten; Vincent Wekker; Anne Bakker; Henk Groen; Miranda Olff; Annemieke Hoek; Ellen T M Laan; Tessa J Roseboom Journal: Eur J Psychotraumatol Date: 2020-06-16