Li Arthur Sone-Wai, Van Niekerk Leesa, Wong Aquina Lim Yim, Matthewson Mandy, Garry Michael
School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia.
Scand J Pain. 2022 Aug 9;23(1):25-39. doi: 10.1515/sjpain-2022-0049. Print 2023 Jan 27.
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex condition. Despite recommendations for the inclusion of non-pharmacological treatment in the management of CP/CPPS, the focus has predominantly been on the inclusion of physical therapies with minimal discussion of psychological interventions. Therefore, this systematic review aimed to evaluate peer-reviewed studies of psychological interventions for men with CP/CPPS to determine their therapeutic efficacy and quality of intervention.
The review was registered in PROSPERO and based on PRISMA 2020 protocol. The systematic literature search was conducted in six databases. Quantitative studies of psychological intervention for adult men with CP/CPPS that provided outcome measures of pain, quality of life and/or psychological symptoms were reviewed. The Oxford level of evidence and Quality Assessment Tool for Quantitative Studies developed by the Effective Public Health Practice were employed.
A total of 4,503 studies were reviewed; seven met the inclusion criteria. The included studies were randomised controlled trials, cohort, repeated measures, and case-series studies, with most including combined treatment for CP/CPPS. Cognitive therapy, cognitive behavioural therapy, or paradoxical relaxation training were found to be effective. However, high risks of bias were found in all included studies, limiting the generalisability and reliability of findings.
Evidence is preliminary but shows promise for psychological treatment either as a combined or standalone treatment for CP/CPPS. However, there is a need to develop research with a more rigorous methodology to evaluate psychological treatments for men with CP/CPPS.
慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)是一种复杂的病症。尽管有建议在CP/CPPS的管理中纳入非药物治疗,但重点主要放在了物理治疗上,对心理干预的讨论极少。因此,本系统评价旨在评估针对患有CP/CPPS的男性进行心理干预的同行评审研究,以确定其治疗效果和干预质量。
该评价已在国际前瞻性系统评价注册库(PROSPERO)中登记,并基于PRISMA 2020方案进行。在六个数据库中进行了系统的文献检索。对针对成年CP/CPPS男性进行心理干预的定量研究进行了综述,这些研究提供了疼痛、生活质量和/或心理症状的结果测量。采用了牛津证据水平和有效公共卫生实践开发的定量研究质量评估工具。
共审查了4503项研究;七项符合纳入标准。纳入的研究为随机对照试验、队列研究、重复测量研究和病例系列研究,大多数研究包括CP/CPPS的联合治疗。发现认知疗法、认知行为疗法或矛盾放松训练是有效的。然而,所有纳入研究均存在高偏倚风险,限制了研究结果的普遍性和可靠性。
证据是初步的,但显示出心理治疗作为CP/CPPS联合治疗或单独治疗的前景。然而,需要开展方法更严谨的研究,以评估针对患有CP/CPPS的男性的心理治疗。