title: Assessing psychological factors, social aspects and psychiatric co-morbidity associated with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) in men -- a systematic review.
abstract: OBJECTIVE
  Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a chronic pain disease with high prevalence rates and substantial health care costs. An interdisciplinary classification system is commonly used (UPOINT) which includes psychosocial factors. Nevertheless, psychosocial influences on CP/CPPS only recently became a research focus. Therefore, we aimed to synthesize the existing data and to identify further research topics. Then, based on our results, diagnosis and treatment can be improved.
  
  
  METHODS
  In a systematic review conducted according to the PRISMA reporting guidelines we searched different databases (MEDLINE, EMBASE, PsychINFO) using the broad search terms "chronic pelvic pain syndrome AND men". Two raters independently screened the literature and assessed the risk of bias.
  
  
  RESULTS
  We included 69 original research articles which considered psychosocial variables. We found studies investigating different psychosocial factors (pain catastrophizing, stress, personality factors, social aspects), co-morbid psychiatric disorders (depression, anxiety and trauma-related disorders, somatization disorder, substance abuse) and Quality of Life (QoL). In addition, there is a high risk of bias in most studies e.g. concerning the study design or the measures.
  
  
  CONCLUSIONS
  There is evidence suggesting that psychological factors are important in understanding CP/CPPS. However, research concentrated on a few aspects while the others were not covered adequately. We found evidence of a higher number of psychosocial factors and psychiatric co-morbidities than is currently included in the UPOINT system. More high quality research is needed to understand the interplay of psychosocial factors in CP/CPPS. Furthermore, these factors should be incorporated into treatment approaches.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf and Schön Klinik Hamburg Eilbek, Hamburg, Germany. Electronic address: b.riegel@uke.de.
authors.forename: Björn
authors.initials: B
authors.lastname: Riegel
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf and Schön Klinik Hamburg Eilbek, Hamburg, Germany.
authors.forename: Christian A
authors.initials: CA
authors.lastname: Bruenahl
authors.affiliation: Department of Urology, University Medical Centre Hamburg-Eppendorf, Germany.
authors.forename: Sascha
authors.initials: S
authors.lastname: Ahyai
authors.affiliation: Department of Neurology, University Medical Centre Hamburg-Eppendorf, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Bingel
authors.affiliation: Department of Urology, University Medical Centre Hamburg-Eppendorf, Germany.
authors.forename: Margit
authors.initials: M
authors.lastname: Fisch
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf and Schön Klinik Hamburg Eilbek, Hamburg, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Löwe
mesh_terms: D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D059350:Chronic Pain / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D015897:Comorbidity; D016208:Databases, Factual; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D017699:Pelvic Pain / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D015995:Prevalence; D011472:Prostatitis / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D011788:Quality of Life; D013001:Somatoform Disorders / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology
keywords: Chronic prostatitis with Chronic pelvic pain syndrome; Mental disorder; Psychosocial aspects; Quality of life; Systematic review