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.