Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, Tennessee.
Department of Physical Medicine and Rehabilitation, Vanderbilt University School of Medicine, Nashville, Tennessee.
Neurourol Urodyn. 2018 Mar;37(3):926-941. doi: 10.1002/nau.23421. Epub 2017 Oct 9.
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.
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.
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).
The psychological impact of IC/BPS is pervasive and severe. Existing evidence of treatment is lacking and suggests self-management intervention may be helpful.
心理社会因素会加重间质性膀胱炎/膀胱疼痛综合征（IC/BPS）的症状。虽然心理社会自我管理在其他疼痛病症中是有效的，但它对 IC/BPS 患者群体的影响很少被研究。本综述的目的是了解心理社会因素对 IC/BPS 的普遍性和影响，评估基线心理社会特征，并为评估和治疗提供建议。
根据 PRISMA 指南，主要信息来源是 PubMed，包括 MEDLINE、Embase、CINAHL 和 Google Scholar。纳入标准包括：（i）明确界定的 IC/BPS 队列或慢性盆腔疼痛综合征队列，前提是 IC/BPS 队列是通过主要队列的定量结果划定的；（ii）所有性别和地区；（iii）1995 年至 2017 年 4 月 14 日期间以英文发表的研究；（iv）作为结局测量或至少作为基线特征的心理社会因素的定量报告。
对最初 642 篇文章中的 34 篇进行了综述。定量分析表明，IC/BPS 患者存在严重的心理社会困难，在所有测量指标上都差于平均水平，在 10 项测量指标中有 7 项属于临床关注领域。基于对 2912 名患者的短式健康调查（SF-12）心理成分量表（MCS）的荟萃分析，平均得分为 40.80（SD 6.25），其中 <36 与严重心理损伤一致。跨研究平均来看，患者的得分范围与临床抑郁症（CES-D 19.89，SD 13.12，N=564）和广泛性焦虑障碍（HADS-A 8.15，SD 4.85，N=465）一致。
IC/BPS 的心理影响普遍且严重。现有治疗证据不足，表明自我管理干预可能有帮助。
