Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Physiotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Psychosom Res. 2019 May;120:1-7. doi: 10.1016/j.jpsychores.2019.02.010. Epub 2019 Feb 21.
To investigate the combined impact of somatic and psychosocial factors on symptom severity and physical and mental quality of life (QoL) in male and female patients with chronic pelvic pain syndrome (CPPS).
We examined 234 patients aged 18 to 84 years attending an interdisciplinary outpatient clinic for patients with CPPS in Hamburg, Germany. Using self-reports, we assessed CPPS symptom severity (NIH-CPSI), with the female counterpart of each male anatomical site used in the questionnaire for women; physical and mental QoL (SF-12) as well as symptoms of depression (PHQ-9) and anxiety (GAD-7); pain catastrophizing cognitions (PCS); social support (F-SozU) and medication intake. The presence of trigger and tender points was assessed in a physiotherapy examination. Hierarchical multiple regression analysis was calculated to analyze the contribution of somatic and psychosocial variables on CPPS symptom severity. Analyses were repeated with physical and mental QoL as outcomes.
In the overall model, the intake of pain medication (B = 3.78, SE = 1.25, p = .006), the presence of depressive symptoms (B = 0.40, SE = 0.15, p = .01) and pain catastrophizing (B = 0.18, SE = 0.05, p = .001) significantly predicted CPPS symptom severity. Corresponding analyses revealed a differential pattern of factors predicting physical and mental QoL, whereas higher levels of depressive symptoms were consistently associated with diminished mental (B = -0.63; p < .001) and physical QoL (B = -0.85; p < .001).
Present results emphasize the importance of psychosocial factors, in particular of depression, in CPPS symptom severity and both physical and mental QoL and give support to an integrated treatment concept encompassing both psychological support and somatic aspects of the disease.
研究躯体和心理社会因素对慢性盆腔疼痛综合征（CPPS）男性和女性患者症状严重程度以及身体和精神生活质量（QoL）的综合影响。
我们检查了 234 名年龄在 18 至 84 岁之间的患者，他们在德国汉堡的一个跨学科门诊就诊，接受 CPPS 治疗。我们使用自我报告评估 CPPS 症状严重程度（NIH-CPSI），问卷中男性的每个解剖部位都有女性的对应部位；身体和精神 QoL（SF-12）以及抑郁症状（PHQ-9）和焦虑症状（GAD-7）；疼痛灾难化认知（PCS）；社会支持（F-SozU）和药物摄入。在物理治疗检查中评估触发点和压痛点的存在。进行分层多元回归分析以分析躯体和心理社会变量对 CPPS 症状严重程度的贡献。分析结果与身体和精神 QoL 作为结果重复。
在总体模型中，疼痛药物的摄入（B=3.78，SE=1.25，p=.006）、抑郁症状的存在（B=0.40，SE=0.15，p=.01）和疼痛灾难化（B=0.18，SE=0.05，p=.001）显著预测 CPPS 症状严重程度。相应的分析显示出预测身体和精神 QoL 的因素的不同模式，而较高水平的抑郁症状与精神（B=-0.63；p<.001）和身体 QoL（B=-0.85；p<.001）的下降持续相关。
目前的结果强调了心理社会因素的重要性，特别是抑郁，在 CPPS 症状严重程度以及身体和精神 QoL 中，并为包括心理支持和疾病躯体方面在内的综合治疗概念提供支持。
