Brünahl Christian, Dybowski Christoph, Albrecht Rebecca, Riegel Björn, Höink Johanna, Fisch Margit, Löwe Bernd
Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf and Schön Klinik Hamburg Eilbek, Hamburg, Germany.
Department of Gynecology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
J Psychosom Res. 2017 Jul;98:19-26. doi: 10.1016/j.jpsychores.2017.04.011. Epub 2017 Apr 22.
Chronic pelvic pain syndrome (CPPS) is a debilitating pain condition with prevalence rates between 2.0% and 26.6%. Studies indicate that CPPS is often associated with psychosocial factors, but little is known about the presence of full-blown mental disorders in female and male patients with CPPS. Therefore, the aim of this study was to investigate the frequencies of mental disorders in patients with CPPS.
Cross-sectional data were collected from patients visiting a specialized outpatient clinic. Frequencies of mental disorders were investigated using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and compared to the general population. Furthermore, self-rating questionnaires were used to assess somatic symptom severity (PHQ-15), depression severity (PHQ-9) and anxiety severity (GAD-7).
Data from 178 CPPS patients (60.1% female; age M=49.1, SD=18.0) were analyzed. Of the total sample, 95.2% (95% CI 90.8-97.9) suffered from at least one mental disorder. The most prevalent mental disorders were somatoform disorders (91.7%; 95% CI 86.4-95.4), followed by mood disorders (50.6%; 95% CI 42.8-58.4) and anxiety disorders (32.1%; 95% CI 25.2-39.8). The self-reported symptom burden was also significantly higher than in the general population. Compared to men, women met the diagnoses of somatoform (p=0.012) and anxiety disorders (p=0.027) significantly more often and reported a significantly higher total somatic symptom severity (p=0.001).
Our results provide evidence for a clinically relevant psychosocial symptom burden in patients with CPPS, indicating the need for the examination of psychopathologies and multi-professional treatment for this patient group.
慢性盆腔疼痛综合征（CPPS）是一种使人衰弱的疼痛病症，患病率在2.0%至26.6%之间。研究表明，CPPS常与心理社会因素相关，但对于患有CPPS的女性和男性患者中是否存在全面的精神障碍知之甚少。因此，本研究的目的是调查CPPS患者中精神障碍的发生率。
收集来自一家专门门诊的患者的横断面数据。使用《精神疾病诊断与统计手册》第四版轴I障碍的结构化临床访谈（SCID-I）调查精神障碍的发生率，并与普通人群进行比较。此外，使用自评问卷评估躯体症状严重程度（PHQ-15）、抑郁严重程度（PHQ-9）和焦虑严重程度（GAD-7）。
分析了178例CPPS患者的数据（60.1%为女性；年龄M = 49.1，SD = 18.0）。在总样本中，95.2%（95%置信区间90.8 - 97.9）患有至少一种精神障碍。最常见的精神障碍是躯体形式障碍（91.7%；95%置信区间86.4 - 95.4），其次是情绪障碍（50.6%；95%置信区间42.8 - 58.4）和焦虑障碍（32.1%；95%置信区间25.2 - 39.8）。自我报告的症状负担也显著高于普通人群。与男性相比，女性更常被诊断为躯体形式障碍（p = 0.012）和焦虑障碍（p = 0.027），并且报告的总体躯体症状严重程度显著更高（p = 0.001）。
我们的结果为CPPS患者存在临床上相关的心理社会症状负担提供了证据，表明需要对该患者群体进行精神病理学检查和多专业治疗。
