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Cited by 18Urinary Bladder and Prostate ResearchPsychosomatic Disorders and Their TreatmentsPelvic floor disorders treatments

Cognition, Emotion, and the Bladder: Psychosocial Factors in Bladder Pain Syndrome and Interstitial Cystitis (BPS/IC)

Open access
Windgassen, Sula, McKernan, Lindsey·2020·Current Bladder Dysfunction Reports
DOI 10.1007/s11884-019-00571-2PMC PMC7810165
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Abstract

Purpose of Review: To review findings from empirical studies assessing the role of psychosocial factors in bladder pain syndrome and interstitial cystitis (BPS/IC). Recent Findings: There is a high rate of psychosocial comorbidity in BPS/IC, including elevated levels of anxiety and depression. Recent studies assessing the role of illness perceptions in BPS/IC relate poorer illness perceptions to more unhelpful illness coping patterns. Conversely, positive illness perceptions including self-efficacy in illness management are associated with more adaptive coping behaviors such as exercising and acceptance. New research is investigating the role of trauma in BPS/IC and the impact of suicidality. There is a paucity of psychosocial interventions for BPS/IC over the last 5 years. The three small-scale studies reviewed included a mindfulness-based stress reduction (MBSR) intervention tailored for BPS/IC, a brief self-management intervention designed to increase patient knowledge and symptom management techniques and a 90-min interview aimed at increasing awareness about physiological affective relationship in IC. Summary: Illness-related cognitions impact illness-related coping behavior, distress, symptom severity, and QoL in BPS/IC. Positive illness perceptions can positively impact behavioral responses to illness and illness outcomes. Trauma, emotion regulation, and suicidality in BPS/IC are important factors for psychosocial interventions and multidisciplinary treatments to address. Insight from the existing evidence base and other functional illness areas such as IBS can be used to inform the design and assessment of interventions aimed to understand and treat BPS/IC as a biopsychosocial illness. The role of healthcare practitioners is fundamental to informing patient perceptions of their illness and providing adequate support for their own self-management approaches. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.

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Crossref · 10.1007/s11884-019-00571-2

Cites

52 of 52 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

34 of 92 cited sources checked · 9 supported · 1 flagged · accuracy not yet measured

  • Premisecitation

    More positive illness perceptions, such as perceived control over illness and treatment, are significantly associated with positive coping behaviors.

    “In contrast, more positive illness perceptions—such as having perceived control over illness and treatment—was significantly associated with positive coping behaviors.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [20] Vasudevan V, Moldwin R. Addressing quality of life in the patient with interstitial cystitis/bladder pain syndrome. Asian J Urol. 2017;4(1):50–4. source

      Section 2.7 (page unavailable) links poor coping strategies to poorer quality of life, but does not address whether perceived control over illness or treatment is associated with positive coping behaviors. Searches for those perceptions and their relationship to coping found no supporting passage in our copy. (LLM, conf=0.72)

      Experimental — accuracy not yet measured
  • Premisecitation

    Perception of more serious negative consequences and concerns about symptoms is associated with greater pain, BPS/IC symptoms and disability.

    “Specifically, the perception of more serious negative consequences and concerns about symptoms is associated with greater pain, BPS/IC symptoms and disability [20].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [20] Vasudevan V, Moldwin R. Addressing quality of life in the patient with interstitial cystitis/bladder pain syndrome. Asian J Urol. 2017;4(1):50–4. source

      Section 2.7 (page not available) says that catastrophizing or anxiously worrying about pain has a significant impact on quality of life in IC/BPS. It does not report that perceptions of serious consequences or concerns about symptoms are associated specifically with greater pain, IC/BPS symptoms, and disability. (LLM, conf=0.82)

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  • Premisecitation

    The impact of BPS/IC spans day-to-day functioning such as travel, daily activities, sleep, diet and sexual functioning.

    “The impact spans day-to-day functioning such as travel, ability to participate in daily activities, sleep, diet and sexual functioning [6, 18].”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [6] Nickel JC, Tripp DA, Beiko D, Tolls V, Herschorn S, Carr LK, et al. The interstitial cystitis/bladder pain syndrome clinical picture: a perspective from patient life experience. Urol Pract. 2018;5(4):286–92. source
    • cites [18] Hepner KA, Watkins KE, Elliott MN, Clemens JQ, Hilton LG, Berry SH. Suicidal ideation among patients with bladder pain syndrome/interstitial cystitis. Urology. 2012;80(2):280–5. source

      The Introduction (page unavailable) says BPS/IC symptoms can affect work, family, interpersonal relationships, sleep, and sexual activity, supporting the broad point about day-to-day functioning. It does not mention travel or diet, so those specific examples are not supported by this source. (LLM, conf=0.88)

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  • Premisecitation

    Women 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].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [16] McKernan LC, Johnson BN, Reynolds WS, Williams DA, Cheavens JS, Dmochowski RR, et al. Posttraumatic stress disorder in interstitial cystitis/bladder pain syndrome: relationship to patient phenotype and clinical practice implications. Neurourol Urodynam. 2019b;38(1):353–62. source
  • Premisecitation

    Exposure to abuse and historical trauma is more prevalent in people with BPS/IC than in the general population.

    “Previous research demonstrated a higher prevalence of exposure to abuse and historical trauma in those with BPS/IC compared to the general population [13, 14].”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [13] •• McKernan LC, Walsh CG, Reynolds WS, Crofford LJ, Dmochowski RR, Williams DA. Psychosocial co-morbidities in interstitial cystitis/bladder pain syndrome (IC/BPS): a systematic review. Neurourol Urodynam. 2018;37(3):926–41 This review comprehensively collates studies assessing the role of psychosocial factors in IC/BPS. source

      The review’s “Trauma Sequelae” section reports abuse prevalence of 25–49% among patients with IC/BPS and childhood traumatic-event exposure of 21–40%. Its “Implications for Assessment” section says a relationship between trauma exposure and IC/BPS has been established. Neither passage establishes that abuse or historical trauma is more prevalent in these patients than in the general population, which is the comparison the citing sentence attributes to this source. (LLM, conf=0.82)

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    • cites [14] McKernan LC, Nash M, Carr ER. An integrative trauma-based approach toward chronic pain: specific applications to interstitial cystitis/bladder pain syndrome. J Psychother Integr. 2016;26(4):378. source
  • May combine two claims. 30
  • Classified as probably not a substantial claim. 6

  • May combine two claims.

    Premisecitation

    In a study of 2,765 individuals with BPS/IC, symptom severity, depression and comorbidity impacted ability to work, increasing sick days and withdrawal from work.

    “Further, a recent study of 2,765 individuals with BPS/IC indicated that symptom severity, depression and comorbidity impacted on individuals’ ability to work culminating in increased days off sick and withdrawal from work [19].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [19] Tripp DA, Nickel JC, Krsmanovic A, Pontari M, Moldwin R, Mayer R, et al. Depression and catastrophizing predict suicidal ideation in tertiary care patients with interstitial cystitis/bladder pain syndrome. Can Urol Assoc J. 2016;10(11–12):383–8. source

      The Abstract describes a study of 190 patients with IC/BPS, not 2,765. The Results examine suicidal ideation and identify depression as its strongest predictor; they do not report increased sick days or withdrawal from work. The claimed study size directly conflicts with this source. (LLM, conf=0.88)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    BPS/IC is underdiagnosed, and its prevalence may be higher than reported.

    “however, recent research suggests that BPS/IC is underdiagnosed and prevalence rates may be higher than reported [4].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [4] Kanter G, Volpe KA, Dunivan GC, Cichowski SB, Jeppson PC, Rogers RG, et al. Important role of physicians in addressing psychological aspects of interstitial cystitis/bladder pain syndrome (IC/BPS): a qualitative analysis. Int Urogynecol J. 2017;28(2):249–56. source

  • May combine two claims.

    Premisecitation

    Before the last five years, research on psychosocial factors in BPS/IC was scarce compared with similar conditions, and findings across studies had been little collated.

    “Prior to the last 5 years, there had been a scarcity of research on psychosocial factors compared to that in similar conditions [11], with little collation of findings across existing studies.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [11] Clemens JQ, Mullins C, Kusek JW, Kirkali Z, Mayer EA, Rodríguez LV, et al. The MAPP research network: a novel study of urologic chronic pelvic pain syndromes. BMC Urol. 2014;14:57. source

      The Background describes earlier UCPPS research and efforts to integrate findings across MAPP protocols, but does not assess whether psychosocial research on IC/BPS was scarcer than research on similar conditions or whether findings from existing studies had been little collated. Searches for psychosocial factors, comparisons with similar conditions, and collation of prior findings found no passage establishing those claims. (LLM, conf=0.72)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Negative illness perceptions are associated with increased unhelpful coping behaviors such as pain guarding, resting and soliciting assistance, and decreased positive coping behaviors such as exercising, relaxing, seeking social support and self-talk.

    “One study found that negative illness perceptions were associated with increased unhelpful coping behaviors such as pain guarding, resting and soliciting assistance and decreased positive coping behaviors such as exercising, relaxing, seeking social support and self-talk [20].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [20] Vasudevan V, Moldwin R. Addressing quality of life in the patient with interstitial cystitis/bladder pain syndrome. Asian J Urol. 2017;4(1):50–4. source

      Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Illness perceptions predict emotion regulation, which impacts physical disability and mental health outcomes in BPS/IC.

    “Illness perceptions were also found to be predictive of emotion regulation, impacting both physical disability and mental health outcomes in BPS/IC [20].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [20] Vasudevan V, Moldwin R. Addressing quality of life in the patient with interstitial cystitis/bladder pain syndrome. Asian J Urol. 2017;4(1):50–4. source

      Section 2.7 ('Other concerns'; page unavailable) links poor coping strategies to poorer quality of life, but does not discuss illness perceptions predicting emotion regulation. Searches for that relationship and its proposed effects on physical disability and mental health found no passage addressing the claimed chain. (LLM, conf=0.74)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    The centralized pain phenotype in BPS/IC is associated with increased emotional distress, psychiatric comorbidity, catastrophizing and poorer quality of life.

    “There is building evidence of the association with this phenotype with increased emotional distress, psychiatric comorbidity, catastrophizing and poorer QoL [32, 33, 35].”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites [32] McKernan LC, Johnson BN, Crofford LJ, Lumley MA, Bruehl S, Cheavens JS. Posttraumatic stress symptoms mediate the effects of trauma exposure on clinical indicators of central sensitization in patients with chronic pain. Clin J Pain. 2019a;35(5):385–93. source

      The Results report an association between PTSD symptoms and clinical indicators of central sensitization, supporting the psychiatric-symptom aspect of the claim in a mixed chronic-pain sample. The Results list BPS/IC among participants’ diagnoses but do not analyze that subgroup separately. Catastrophizing was not an outcome, and the Discussion’s mention of quality of life is a proposed treatment implication, not a measured association (page numbers unavailable). (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [33] Lai HH, Jemielita T, Sutcliffe S, Bradley CS, Naliboff B, Williams DA, et al. Characterization of whole body pain in urological chronic pelvic pain syndrome at baseline: a MAPP Research Network Study. J Urol. 2017;198(3):622–31. source

      The Results (Psychosocial Health and Quality of Life; page not provided) associate more widespread pain with greater depression, anxiety and stress, and poorer general quality of life. They report a catastrophizing trend in women, not both sexes. The Discussion describes widespread pain as possibly indicating a centralized pain syndrome; the paper does not establish centralization or report diagnosed psychiatric comorbidity. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
    • cites [35] Tripp DA, Nickel JC, Wong J, Pontari M, Moldwin R, Mayer R, et al. Mapping of pain phenotypes in female patients with bladder pain syndrome/interstitial cystitis and controls. Eur Urol. 2012;62(6):1188–94. source

  • May combine two claims.

    Premisecitation

    Central sensitization disrupts regular processing of pain and can contribute to overlapping conditions such as irritable bowel syndrome and fibromyalgia.

    “Central sensitization therefore disrupts regular processing of pain, which can contribute to a broad range of overlapping conditions such as irritable bowel syndrome and fibromyalgia [30].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [30] Grundy L, Caldwell A, Brierley S. Mechanisms underlying overactive bladder and interstitial cystitis/bladder pain syndrome. Front Neurosci. 2018;12:931. source

      The Introduction (page not available) describes changes in peripheral or central sensory pathways that can alter bladder sensation. Cross-Organ Sensitisation (page not available) discusses IBS in relation to subsequent bladder pathology, but does not say central sensitization causes IBS; the searched passages also do not connect it to fibromyalgia. The claim therefore extends a bladder-focused account to conditions the paper does not establish as consequences of central sensitization. (LLM, conf=0.83)

      Experimental — accuracy not yet measured

  • Classified as probably not a substantial claim.

    Premisecitation

    High cognitive alexithymia and low affective alexithymia mediate the correlations between childhood trauma and dissociation and bladder capacity.

    “Chiu et al [27] found that high cognitive alexithymia and low affective alexithymia mediated the correlations between childhood trauma and dissociation and bladder capacity.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [27] Tripp D, Crawford A, Curtis Nickel J, Moldwin R, Carr L, Mayer R, et al. MP39-20 the longitudinal role of catastrophizing and emotion regulation in the relationship between depression and pain in women with interstitial cystitis/bladder pain syndrome. J Urol. 2018;199:e518. source

      The Results in the indexed Additional information passage report that catastrophizing mediated the relationship between baseline depression and later pain in women with IC/BPS. Searches for cognitive and affective alexithymia, childhood trauma, dissociation, bladder capacity, and Chiu found no passage addressing the claimed relationship. No page number is available in our copy. (LLM, conf=0.76)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Katz et al. did not find emotion regulation to mediate the relationship between depression and pain, which would be expected if alexithymia accounted for symptom experience.

    “Furthermore, Katz et al [20] did not find emotion regulation to mediate the relationship between depression and pain, which it would be expected to, should alexithymia account for symptom experience.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [20] Vasudevan V, Moldwin R. Addressing quality of life in the patient with interstitial cystitis/bladder pain syndrome. Asian J Urol. 2017;4(1):50–4. source

      Section 2.2 (Anxiety/depression) discusses depressive symptoms and quality of life, and section 2.7 (Other concerns) mentions depression and pelvic pain. Neither reports a Katz et al. finding about emotion regulation mediating depression and pain or addresses alexithymia; searches for those terms found no relevant passage. Page numbers were not available in our copy. (LLM, conf=0.76)

      Experimental — accuracy not yet measured

  • Classified as probably not a substantial claim.

    Premisecitation

    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].”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [16] McKernan LC, Johnson BN, Reynolds WS, Williams DA, Cheavens JS, Dmochowski RR, et al. Posttraumatic stress disorder in interstitial cystitis/bladder pain syndrome: relationship to patient phenotype and clinical practice implications. Neurourol Urodynam. 2019b;38(1):353–62. source

      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 measured
    • cites [27] Tripp D, Crawford A, Curtis Nickel J, Moldwin R, Carr L, Mayer R, et al. MP39-20 the longitudinal role of catastrophizing and emotion regulation in the relationship between depression and pain in women with interstitial cystitis/bladder pain syndrome. J Urol. 2018;199:e518. source

      The cited abstract’s Results (page unavailable) examine whether catastrophizing mediates the relationship between depression and pain in women with IC/BPS. Searches for childhood relational trauma, dissociation, and higher versus lower bladder capacity found no passage addressing the claimed correlation. (LLM, conf=0.76)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Studies in the past five years have begun to demonstrate an association between psychosocial factors and bladder microbiome and inflammation, but precise mechanisms are not established.

    “In the past 5 years studies have begun to demonstrate an association between psychosocial factors and bladder microbiome and inflammation [39, 40, 41]; however, precise mechanisms of these interactions are yet to be established.”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites [39] Jhang J-F, Kuo H-C. Pathomechanism of interstitial cystitis/bladder pain syndrome and mapping the heterogeneity of disease. Int Neurourol J. 2016;20(Suppl 2):S95–104. source

      The 'Mapping the Heterogeneity of IC/BPS' section mentions comorbid mental illnesses and small-intestinal bacterial overgrowth, while the inflammation sections discuss bladder inflammatory findings. None links psychosocial factors to the bladder microbiome or to inflammation. Searches for 'psychosocial' and 'microbiome' found no passage establishing the attributed association; page numbers were not available in our copy. (LLM, conf=0.75)

      Experimental — accuracy not yet measured
    • cites [40] Graziottin A, Skaper SD, Fusco M. Mast cells in chronic inflammation, pelvic pain and depression in women. Gynecol Endocrinol. 2014;30(7):472–7. source
    • cites [41] Nickel JC, Irvine-Bird K, Jianbo L, Shoskes DA. Phenotype-directed management of interstitial cystitis/bladder pain syndrome. Urol. 2014;84(1):175–9. source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The importance of patient-centred care and decision making has been identified in BPS/IC and in chronic condition management generally.

    “The importance of patient-centred care and decision making has previously been identified in BPS/IC [44] but also more generally in chronic condition management [48, 49].”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites [44] Meijlink JM. Bladder pain: the patient perspective. Urologia J. 2017;84(1_suppl):5–7. source
    • cites [48] Montori VM, Gafni A, Charles C. A shared treatment decision-making approach between patients with chronic conditions and their clinicians: the case of diabetes. Health Expect. 2006;9(1):25–36. source
      Experimental — accuracy not yet measured
    • cites [49] Kanter G, Komesu YM, Qaedan F, Jeppson PC, Dunivan GC, Cichowski SB, et al. Mindfulness-based stress reduction as a novel treatment for interstitial cystitis/bladder pain syndrome: a randomized controlled trial. Int Urogynecol J. 2016;27(11):1705–11. source

      The Discussion (page not available) describes MBSR for IC/BPS as patient-centred care that enables patients to manage their symptoms themselves. It does not identify patient-centred decision making; the broader claim about chronic-condition management is attributed to other citations, not this paper. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S4 (based).

    Findingnone given

    There have been no cognitive behavioral therapy trials in BPS/IC in the last five years.

    “It is therefore surprising that there have not been any cognitive behavioral therapy trials in the last 5 years.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The review's literature search identified all relevant psychosocial intervention studies in BPS/IC over the last five years.

  • May combine two claims.

    Findingreasoning

    There is recent growth of research into psychosocial factors in BPS/IC, but a shortage of quality research trials assessing psychosocial interventions remains.

    “There is recent growth of research into psychosocial factors in BPS/IC, yet there remains a shortage of quality research trials assessing psychosocial interventions for this patient population.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The review's literature search identified all relevant psychosocial intervention studies in BPS/IC over the last five years.

  • May combine two claims.

    Findingcitation

    In the last five years, only three psychosocial intervention studies were conducted to the authors' knowledge: a mindfulness-based stress reduction course, an online video-education system, and a 90-minute interview.

    “The only three studies conducted to the best of our knowledge, included a mindfulness-based stress reduction course [50], an online video-education system [51] and a 90-minute interview aimed at facilitating the link between stress, emotional conflict, symptoms and encouraging emotional expression [52].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [50] Lee M-H, Wu H-C, Tseng C-M, Ko T-L, Weng T-J, Chen Y-F. Health education and symptom flare management using a video-based m-health system for caring women with IC/BPS. Urol. 2018;119:62–9. source
    • cites [51] Carty J, Lumley M, Holmes H, Tomakowsky J, Schubiner H, Dove-Medows E, et al. (516) The effects of a stress and emotion interview for women with urogenital pain: a randomized trial. J Pain. 2016;17(4):S103. source
    • cites [52]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • Rests on an assumption: The review's literature search identified all relevant psychosocial intervention studies in BPS/IC over the last five years.

  • May combine two claims.

    Premisecitation

    BPS/IC is associated with a high rate of psychosocial comorbidity, including elevated anxiety and depression.

    “There is a high rate of psychosocial comorbidity in BPS/IC, including elevated levels of anxiety and depression.”
    • Also stated in: § BPS/IC and Psychological Co-Morbidity · hedged
      “A recent systematic review indicated that psychosocial comorbidity is significantly elevated in those with BPS/IC [12].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [12] Kinsey D, Pretorius S, Glover L, Alexander T. The psychological impact of overactive bladder: a systematic review. J Health Psychol. 2016;21(1):69–81. source

  • May combine two claims.

    Premisecitation

    The BPS/IC subgroup meeting provisional PTSD criteria had poorer outcomes, including higher pain severity, more emotional distress and worse quality of life.

    “This subgroup was associated with poorer outcomes overall including higher pain severity, more emotional distress and worse quality of life (QoL).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [15] Peters KM, Kalinowski SE, Carrico DJ, Ibrahim IA, Diokno AC. Fact or fiction—is abuse prevalent in patients with interstitial cystitis? Results from a community survey and clinic population. J Urol. 2007;178(3):891–5. source

  • May combine two claims.

    Premisecitation

    High tendencies to self-sacrifice increase distress and exacerbate pain in women with BPS/IC.

    “In addition, high tendencies to self-sacrifice were found to increase distress and exacerbate pain in women with BPS/IC [22].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [22] Katz L, Tripp DA, Carr LK, Mayer R, Moldwin RM, Nickel JC. Understanding pain and coping in women with interstitial cystitis/bladder pain syndrome. BJU Int. 2017;120(2):286–92. source

  • May combine two claims.

    Interpretationreasoning

    Cognitions, coping, mood and emotion regulation are strongly intertwined and substantially impact severity and quality-of-life outcomes in BPS/IC, and may be important targets for psychosocial intervention.

    “These findings demonstrate that cognitions, coping, mood and emotion regulation are factors that are strongly intertwined with a substantial impact on severity and QoL outcomes in BPS/IC, and may prove important targets for psychosocial intervention.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Suicidal ideation and attempts are substantially higher in BPS/IC.

    “Previously, research noted substantially higher suicidal ideation and attempts in BPS/IC [17].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Chiu C-D, Lee M-H, Chen W-C, Ho HL, Wu H-C. Childhood trauma perpetrated by close others, psychiatric dysfunction, and urological symptoms in patients with interstitial cystitis/bladder pain syndrome. J Psychosom Res. 2017b;93:90–5. source

  • May combine two claims.

    Premisecitation

    The three small-scale psychosocial intervention studies reviewed were a tailored mindfulness-based stress reduction intervention, a brief self-management intervention to increase knowledge and symptom management, and a 90-minute interview to increase awareness of the physiological-affective relationship in IC.

    “The three small-scale studies reviewed included a mindfulness-based stress reduction (MBSR) intervention tailored for BPS/IC, a brief self-management intervention designed to increase patient knowledge and symptom management techniques and a 90-minute interview aimed at increasing awareness about physiological-affective relationship in IC.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [50] Lee M-H, Wu H-C, Tseng C-M, Ko T-L, Weng T-J, Chen Y-F. Health education and symptom flare management using a video-based m-health system for caring women with IC/BPS. Urol. 2018;119:62–9. source
    • cites [51] Carty J, Lumley M, Holmes H, Tomakowsky J, Schubiner H, Dove-Medows E, et al. (516) The effects of a stress and emotion interview for women with urogenital pain: a randomized trial. J Pain. 2016;17(4):S103. source
    • cites [52]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Unhelpful coping behaviors mediate the relationship between catastrophizing and affective pain, and depression moderates this relationship.

    “Meure et al [21] found that while unhelpful coping behaviors mediated the relationship between catastrophizing and affective pain, depression moderated this relationship.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Beckett MK, Elliott MN, Clemens JQ, Ewing B, Berry SH. Consequences of interstitial cystitis/bladder pain symptoms on women’s work participation and income: results from a National Household Sample. J Urol. 2014;191(1):83–8. source

  • May combine two claims.

    Premisecitation

    42% of individuals with BPS/IC met provisional diagnostic criteria for PTSD, significantly higher than a general chronic pain comparison group.

    “The first study to assess this in BPS/IC to our knowledge found that 42% of individuals with BPS/IC met provisional diagnostic criteria for PTSD, which was significantly higher than the comparison general chronic pain group [15].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [15] Peters KM, Kalinowski SE, Carrico DJ, Ibrahim IA, Diokno AC. Fact or fiction—is abuse prevalent in patients with interstitial cystitis? Results from a community survey and clinic population. J Urol. 2007;178(3):891–5. source

  • May combine two claims.

    Premisecitation

    Catastrophizing significantly predicts suicidality and depression in tertiary care BPS/IC patients, and depression independently predicts suicidality.

    “Catastrophizing was also found to significantly predict suicidality and depression in tertiary care BPS/IC patients, with depression independently significantly predicting suicidality also [26].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [26] Katz L, Tripp DA, Nickel JC, Krsmanovic A, Muere A, Carr LK, et al. P94: illness perceptions mediate the relationship between pain and depression in women with IC/BPS. Pain Res Manag J Can Pain. 2014;19:e31. source

  • May combine two claims.

    Premisecitation

    Panic disorder, low self-esteem and trauma are common psychosocial comorbidities in BPS/IC.

    “Panic disorder, low self-esteem and trauma were other common psychosocial comorbidities found in BPS/IC.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Kinsey D, Pretorius S, Glover L, Alexander T. The psychological impact of overactive bladder: a systematic review. J Health Psychol. 2016;21(1):69–81. source

  • May combine two claims.

    Interpretationcitation

    An individual's perception of BPS/IC and negative appraisal of symptoms can alter behavior and mood, which in turn worsens pain and urologic symptoms.

    “An individuals’ perception of their disease and negative appraisal of their symptoms can alter behavior and mood, in turn worsening pain and urologic symptoms.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    Positive coping behaviors may improve the ability to regulate strong emotions, and/or emotion regulation may enhance engagement with positive coping behaviors.

    “Although the study design limits causal inference, this suggests that positive coping behaviors (e.g. relaxation, exercise) may positively impact the ability to regulate strong emotions and/or emotion regulation can enhance engagement with positive coping behaviors.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Benefits of the psychosocial interventions included reduction in pain and improvement in symptoms, pain self-efficacy, and improved quality of life.

    “Benefits included reduction in pain and improvement in symptoms [50, 51, 52], pain self-efficacy [50] and improved QoL [51].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [50] Lee M-H, Wu H-C, Tseng C-M, Ko T-L, Weng T-J, Chen Y-F. Health education and symptom flare management using a video-based m-health system for caring women with IC/BPS. Urol. 2018;119:62–9. source
    • cites [51] Carty J, Lumley M, Holmes H, Tomakowsky J, Schubiner H, Dove-Medows E, et al. (516) The effects of a stress and emotion interview for women with urogenital pain: a randomized trial. J Pain. 2016;17(4):S103. source
    • cites [52]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    Research to date suggests the importance of multidisciplinary care and input in BPS/IC management, but this is often not available in practice.

    “The research to date suggests the importance of multidisciplinary care and input in BPS/IC management, however this is often not an option in practice.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Lack of understanding from healthcare providers can be alienating, reduce confidence in medical professionals and self-management, and lead to symptom concealment and disengagement from treatment.

    “This can be alienating and reduce confidence in medical professionals as well as confidence in self-management of BPS/IC and lead to symptom concealment and disengagement from treatment [46, 47].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [46] Epstein RM, Shields CG, Meldrum SC, Fiscella K, Carroll J, Carney PA, et al. Physicians’ responses to patients’ medically unexplained symptoms. Psychosom Med. 2006;68(2):269–76. source
    • cites [47] Ekman I, Swedberg K, Taft C, Lindseth A, Norberg A, Brink E, et al. Person-centered care — ready for prime time. Eur J Cardiovasc Nurs. 2011;10(4):248–51. source

  • May combine two claims.

    Study design and conductreasoning

    The mediation analysis in Chiu et al. was conducted on cross-sectional data, which limits causal inferences.

    “Firstly, the mediation analysis was conducted on cross-sectional data limiting inferences about causality.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given

    BPS/IC is highly prevalent and has extensive impact on the patient and economy.

    “BPS/IC is a highly prevalent condition with extensive impact on the patient and economy.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    BPS/IC patients often encounter many healthcare avenues and experience frustration, dismissiveness and disbelief from practitioners.

    “BPS/IC patients are likely to have had to encounter many different healthcare avenues in pursuit of answers and treatment for symptoms and often experience frustration, dismissiveness and sense of disbelief by practitioners [44].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44] Meijlink JM. Bladder pain: the patient perspective. Urologia J. 2017;84(1_suppl):5–7. source
33 of 33

  • The paper relies on this without support.

    The review's literature search identified all relevant psychosocial intervention studies in BPS/IC over the last five years.

    “There is a paucity of psychosocial interventions for BPS/ICover the last 5 years.”
    “The only three studies conducted to the best of our knowledge, included a mindfulness-based stress reduction course [50], an online video-education system [51] and a 90-minute interview aimed at facilitating the link between stress, emotional conflict, symptoms and encouraging emotional expression [52].”

  • The paper relies on this without support.

    The three small-scale intervention studies are representative enough to support a general conclusion about acceptability of psychosocial interventions in BPS/IC.

    “Although studies had small sample sizes, the findings across studies demonstrated an acceptability of psychosocial interventions BPS/IC.”
2 of 2

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Authors
Windgassen, S., & McKernan, L.
Affiliations
  • King's College London (GB)
  • Vanderbilt University Medical Center (US)
Corresponding author
McKernan, Lindsey
ORCID
Venue
Current Bladder Dysfunction Reports
Publisher
Springer Science and Business Media LLC
Published
2020-01-31
Volume
15
Issue
1
Pages
9-14
ISSN
  • 1931-7212 (ISSN-L)
  • 1931-7220
DOI
10.1007/s11884-019-00571-2
PMC
PMC7810165
OpenAlex
W3003309670
Cited by
18
References
52
Citations by year
2026: 4 · 2025: 4 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 2
FWCI
1.99
Type
journal article
Language
en
Open access
Licence
Locations
  • Current Bladder Dysfunction Reports (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Research Portal (King's College London) (submittedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (L30 DK118656, K23DK118118)
Topics
  • Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
Keywords
interstitial cystitis, psychosocial factors, illness perception, coping, anxiety, depression, self-efficacy, trauma, suicidality, emotion regulation, mindfulness-based stress reduction, self-management interventions, quality of life, biopsychosocial model, multidisciplinary treatment

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

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