title: Relationship between chronic nonurological associated somatic syndromes and symptom severity in urological chronic pelvic pain syndromes: baseline evaluation of the MAPP study.
abstract: OBJECTIVE
  We used MAPP data to identify participants with urological chronic pelvic pain syndromes only or a chronic functional nonurological associated somatic syndrome in addition to urological chronic pelvic pain syndromes. We characterized these 2 subgroups and explored them using 3 criteria, including 1) MAPP eligibility criteria, 2) self-reported medical history or 3) RICE criteria.
  
  
  METHODS
  Self-reported cross-sectional data were collected on men and women with urological chronic pelvic pain syndromes, including predominant symptoms, symptom duration and severity, nonurological associated somatic syndrome symptoms and psychosocial factors.
  
  
  RESULTS
  Of 424 participants with urological chronic pelvic pain syndromes 162 (38%) had a nonurological associated somatic syndrome, including irritable bowel syndrome in 93 (22%), fibromyalgia in 15 (4%), chronic fatigue syndrome in 13 (3%) and multiple syndromes in 41 (10%). Of 233 females 103 (44%) had a nonurological associated somatic syndrome compared to 59 of 191 males (31%) (p = 0.006). Participants with a nonurological associated somatic syndrome had more severe urological symptoms and more frequent depression and anxiety. Of 424 participants 228 (54%) met RICE criteria. Of 228 RICE positive participants 108 (47%) had a nonurological associated somatic syndrome compared to 54 of 203 RICE negative patients (28%) with a nonurological associated somatic syndrome (p < 0.001).
  
  
  CONCLUSIONS
  Nonurological associated somatic syndromes represent important clinical characteristics of urological chronic pelvic pain syndromes. Participants with a nonurological associated somatic syndrome have more severe symptoms, longer duration and higher rates of depression and anxiety. RICE positive patients are more likely to have a nonurological associated somatic syndrome and more severe symptoms. Because nonurological associated somatic syndromes are more common in women, future studies must account for this potential confounding factor in urological chronic pelvic pain syndromes.
authors.affiliation: Department of Urology, University of Washington, Seattle, Washington. Electronic address: jkrieger@uw.edu.
authors.forename: John N
authors.initials: JN
authors.lastname: Krieger
authors.affiliation: Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Alisa J
authors.initials: AJ
authors.lastname: Stephens
authors.affiliation: Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: J Richard
authors.initials: JR
authors.lastname: Landis
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, Michigan.
authors.forename: J Quentin
authors.initials: JQ
authors.lastname: Clemens
authors.affiliation: Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Karl
authors.initials: K
authors.lastname: Kreder
authors.affiliation: Department of Surgery-Division of Urologic Surgery, Washington University St. Louis, St. Louis, Missouri.
authors.forename: H Henry
authors.initials: HH
authors.lastname: Lai
authors.affiliation: Veterans Affairs Center of Excellence for Stress and Mental Health and University of California-San Diego, San Diego.
authors.forename: Niloofar
authors.initials: N
authors.lastname: Afari
authors.affiliation: Department of Urology, University of California-Los Angeles, Los Angeles.
authors.forename: Larissa
authors.initials: L
authors.lastname: Rodríguez
authors.affiliation: Department of Urology, Northwestern University, Chicago, Illinois.
authors.forename: Anthony
authors.initials: A
authors.lastname: Schaeffer
authors.affiliation: Department of Anesthesia-Division of Pain Management, Stanford University, Palo Alto, California.
authors.forename: Sean
authors.initials: S
authors.lastname: Mackey
authors.affiliation: Department of Surgery-Division of Urologic Surgery, Washington University St. Louis, St. Louis, Missouri.
authors.forename: Gerald L
authors.initials: GL
authors.lastname: Andriole
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, Michigan.
authors.forename: David A
authors.initials: DA
authors.lastname: Williams
mesh_terms: D002908:Chronic Disease; D003430:Cross-Sectional Studies; D018856:Cystitis, Interstitial / Q000150:complications / Q000175:diagnosis; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D017699:Pelvic Pain / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D063189:Symptom Assessment; D013577:Syndrome
keywords: cystitis; female; interstitial; male; questionnaires; urinary bladder