title: Psychological distress in twins with urological symptoms.
abstract: OBJECTIVE
  Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic pain condition with unclear underlying etiology. Our objectives were to determine whether psychological distress was higher in twins with urological symptoms commonly found in IC/PBS than in twins without, and if so, did familial influences contribute to this association.
  
  
  METHODS
  Data from 1165 female twins in a community-based sample were used. Urological symptoms, symptoms of posttraumatic stress disorder (PTSD), depression, anxiety and perceived stress were assessed with standardized questionnaires. Generalized estimating equation (GEE) regression models were used to examine the relationship between psychological distress and urological symptoms.
  
  
  RESULTS
  Compared to unaffected twins, twins with urological symptoms were more likely to report PTSD symptoms (OR=3.9; 95% CI=2.6-5.8), depression (OR=3.1; 95% CI=2.0-5.0), anxiety (OR=3.4; 95% CI=2.3-5.2) and perceived stress (OR=3.2; 95% CI=2.1-4.9). After adjusting for familial influences, the within-pair effects remained significant for PTSD symptoms (OR=2.2; 95% CI=1.2-3.8) and perceived stress (OR=2.2; 95% CI=1.2-3.8).
  
  
  CONCLUSIONS
  Familial influences partially explained the relationship between indicators of psychological distress and urological symptoms. Future research should examine shared environmental and genetic mechanisms that may further explain this relationship and improve diagnosis and treatment of this unexplained clinical condition.
authors.affiliation: Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093-0738, USA.
authors.forename: Lisa Johnson
authors.initials: LJ
authors.lastname: Wright
authors.forename: Carolyn
authors.initials: C
authors.lastname: Noonan
authors.forename: Sandra
authors.initials: S
authors.lastname: Ahumada
authors.forename: María Angeles Bullones
authors.initials: MA
authors.lastname: Rodríguez
authors.forename: Dedra
authors.initials: D
authors.lastname: Buchwald
authors.forename: Niloofar
authors.initials: N
authors.lastname: Afari
mesh_terms: D000328:Adult; D018856:Cystitis, Interstitial / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology; D013315:Stress, Psychological; D014427:Twins / Q000523:psychology*; D055815:Young Adult