Huang Xinfei, Qin Zhan, Cui Hongliang, Chen Jianhuai, Liu Tao, Zhu Yongkang, Yuan Shaoying
Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China.
Department of Andrology, Guangdong Provincial Hospital of Chinese Medicine, Zhuhai 519015, China.
Transl Androl Urol. 2020 Apr;9(2):485-493. doi: 10.21037/tau.2020.01.25.
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a chronic disease with a variety of psychosocial and somatic symptoms. CP/CPPS has substantial health care costs with unclear etiology, which may be caused by psychosocial factors. Moreover, previous studies suggested that cognitive processes played a crucial role in the perception of somatic pain. Therefore, the aim of this meta-analysis was to analyze the psychosocial characteristics in men with CP/CPPS, especially the symptom of pain catastrophizing.
Relevant publications were searched in different databases including PubMed, MEDLINE, EMBASE, Google Scholar and the Cochran Library using the search terms of "Chronic prostatitis", "Chronic pelvic pain syndrome", "Psychosocial" and "Catastrophizing". The prevalence of psychological factors and pain catastrophizing in men with CP/CPPS were extracted and calculated.
Ten studies inclusive of 1,308 patients were included. Analysis of NIH-CPSI scores showed that the severity of CP/CPPS was 23.20 (95% CI: 21.13-25.28). The severity of pain catastrophizing was 13.81 (95% CI: 9.83-17.79) estimated by coping strategies questionnaire (CSQ), while the severity of pain catastrophizing was 24.83 (95% CI: 9.19-40.47) estimated by pain catastrophizing scale (PCS). The prevalence of psychosocial symptom was 0.43 (95% CI: 0.32-0.55), while the prevalence of pain catastrophizing was 0.26 (95% CI: 0.21-0.31).
The psychological factors and pain catastrophizing in men with CP/CPPS was serious. Furthermore, the prevalence of psychosocial symptom and pain catastrophizing was high. There might be a link between pain catastrophizing and somatic symptoms in CPPS. Thus, further prospective studies are needed to evaluate the importance of psychosocial factors in symptom severity of CP/CPPS.
慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)是一种伴有多种心理社会和躯体症状的慢性疾病。CP/CPPS的医疗成本高昂,但其病因不明,可能由心理社会因素引起。此外,先前的研究表明,认知过程在躯体疼痛的感知中起着关键作用。因此,本荟萃分析的目的是分析CP/CPPS男性患者的心理社会特征,尤其是疼痛灾难化症状。
在不同数据库(包括PubMed、MEDLINE、EMBASE、谷歌学术和考克兰图书馆)中检索相关出版物,使用“慢性前列腺炎”、“慢性盆腔疼痛综合征”、“心理社会”和“灾难化”等检索词。提取并计算CP/CPPS男性患者心理因素和疼痛灾难化的患病率。
纳入10项研究,共1308例患者。美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)评分分析显示,CP/CPPS的严重程度为23.20(95%置信区间:21.13-25.28)。通过应对策略问卷(CSQ)评估,疼痛灾难化的严重程度为13.81(95%置信区间:9.83-17.79),而通过疼痛灾难化量表(PCS)评估,疼痛灾难化的严重程度为24.83(95%置信区间:9.19-40.47)。心理社会症状的患病率为0.43(95%置信区间:0.32-0.55),而疼痛灾难化的患病率为0.26(95%置信区间:0.21-0.31)。
CP/CPPS男性患者的心理因素和疼痛灾难化情况严重。此外,心理社会症状和疼痛灾难化的患病率较高。CPPS中疼痛灾难化与躯体症状之间可能存在联系。因此,需要进一步的前瞻性研究来评估心理社会因素在CP/CPPS症状严重程度中的重要性。