Posttraumatic stress disorder in interstitial cystitis/bladder pain syndrome: Relationship to patient phenotype and clinical practice implications
Open accessAbstract
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.
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Higher rates of childhood relational trauma and dissociation are more highly correlated with higher bladder capacity than with lower bladder capacity in BPS/IC.
“This hypothesis was based on the findings that higher rates of childhood relational trauma and dissociation were more highly correlated with higher bladder capacity (presumed to denote a non-physiological cause) compared to lower bladder capacity [16, 27].”
From Cognition, Emotion, and the Bladder: Psychosocial Factors in Bladder Pain Syndrome and Interstitial Cystitis (BPS/IC) (2020) · cites this paper as [16]
The Introduction (page unavailable) reports that women with IC/BPS exposed to childhood trauma by close others had more dissociative tendencies and increased anesthetic bladder capacity. It does not compare correlations with higher versus lower bladder capacity, and it presents this as a finding of another study rather than its own analysis. (LLM, conf=0.84)
Experimental — accuracy not yet measuredWomen with BPS/IC who experienced childhood trauma were more likely to have dissociation and increased anxiety.
“Additional recent investigations indicate that women with BPS/IC who experienced childhood trauma were more likely to struggle with disassociation and increased anxiety [16].”
From Cognition, Emotion, and the Bladder: Psychosocial Factors in Bladder Pain Syndrome and Interstitial Cystitis (BPS/IC) (2020) · cites this paper as [16]
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“A recent study(7) indicated that women exposed to trauma in childhood by close others had more anxiety, dissociative tendencies, and increased anesthetic bladder capacity, proposing that psychosocial factors may drive symptoms in this subset of patients.(8) Despite well-known associations between IC/BPS and abuse expo…”
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- Authors
- McKernan, L. C., Johnson, B. N., Reynolds, W. S., Williams, D. A., Cheavens, J. S., Dmochowski, R. R., & Crofford, L. J.
- Affiliations
- Vanderbilt University (US)
- Pennsylvania State University (US)
- Department of Urologic Surgery Vanderbilt University School of Medicine Nashville Tennessee
- University of Michigan (US)
- The Ohio State University (US)
- Corresponding author
- McKernan, Lindsey C.
- ORCID
- Venue
- Neurourology and Urodynamics
- Publisher
- Wiley
- Published
- 2018-10-23
- Volume
- 38
- Issue
- 1
- Pages
- 353-362
- ISSN
- 0733-2467 (ISSN-L)
- 1520-6777
- PMC
- PMC6310618
- OpenAlex
- W2896875605
- Cited by
- 42
- References
- 27
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 4 · 2023: 5 · 2022: 4 · 2021: 11 · 2020: 5
- FWCI
- 5.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurourology and Urodynamics (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- Agency for Healthcare Research and Quality (6K12HS022990‐04)
- National Center for Advancing Translational Sciences (UL1TR000445)
- Topics
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- post-traumatic stress disorder, interstitial cystitis, chronic pain, trauma exposure, sexual abuse, childhood trauma, genitourinary symptoms, emotional distress, quality of life, trauma-informed care, PTSD screening
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Phenotype, Quality of Life, Surveys and Questionnaires, Stress Disorders, Post-Traumatic, Comorbidity, Incidence, Prevalence, Cystitis, Interstitial, Chronic Pain
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