Chiu Chui-De, Lee Ming-Huei, Chen Wei-Chih, Ho Hoi Lam, Wu Huei-Ching
Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
Department of Urology, Feng Yuan Hospital, Taichung, Taiwan.
J Psychosom Res. 2017 Feb;93:90-95. doi: 10.1016/j.jpsychores.2016.12.014. Epub 2016 Dec 27.
A psychosocial phenotype of interstitial cystitis/bladder pain syndrome (IC/BPS), a urogenital condition without known organic causes, was proposed. While psychosocial variables, including interpersonal maltreatment and negative affect, were studied in association with IC/BPS, the specificities of the relationships between childhood trauma by close others, psychiatric dysfunctions (negative affect and post-traumatic psychopathology), and urogenital symptoms have not been established.
94 IC/BPS patients were recruited together with 47 patients with acute cystitis who served as clinical controls. Standardized scales were used to assess various potentially traumatizing events in childhood and adulthood as well as psychiatric (dissociation and negative affect) and urogenital symptoms.
Among the potentially traumatizing events, those perpetrated by close others during childhood were found to be the most salient features discriminating the IC/BPS group from the control group. When divided into 2 subgroups according to their history of childhood trauma by close others, only IC/BPS patients with childhood trauma by close others had more dissociative and anxiety symptoms compared with the control group. These two subgroups did not differ in urogenital symptom severity.
Childhood trauma by close others, rather than other types of interpersonal trauma, was a differentiating characteristic in IC/BPS patients, and a childhood trauma related psychosocial phenotype with a distinct clinical profile of dissociation and anxiety proneness was identified. Future studies should investigate whether a distinct set of pathogenic factors exists in IC/BPS patients with a history of childhood trauma by close others, even if this subgroup is not readily differentiated by urogenital symptoms.
提出了间质性膀胱炎/膀胱疼痛综合征(IC/BPS)的一种社会心理表型,这是一种无已知器质性病因的泌尿生殖系统疾病。虽然对包括人际虐待和负面影响在内的社会心理变量与IC/BPS的相关性进行了研究,但亲密他人造成的童年创伤、精神功能障碍(负面影响和创伤后精神病理学)与泌尿生殖系统症状之间关系的特异性尚未明确。
招募了94例IC/BPS患者以及47例急性膀胱炎患者作为临床对照。使用标准化量表评估童年和成年期各种潜在的创伤性事件以及精神症状(解离和负面影响)和泌尿生殖系统症状。
在潜在的创伤性事件中,发现童年时期由亲密他人实施的创伤性事件是区分IC/BPS组和对照组的最显著特征。根据亲密他人造成的童年创伤史将患者分为两个亚组,只有有亲密他人造成童年创伤的IC/BPS患者与对照组相比有更多的解离和焦虑症状。这两个亚组在泌尿生殖系统症状严重程度上没有差异。
亲密他人造成的童年创伤而非其他类型的人际创伤是IC/BPS患者的一个区分特征,并且识别出了一种与童年创伤相关的社会心理表型,其具有解离和焦虑倾向的独特临床特征。未来的研究应调查在有亲密他人造成童年创伤史的IC/BPS患者中是否存在一组独特的致病因素,即使该亚组在泌尿生殖系统症状方面不易区分。