title: Widespread Psychosocial Difficulties in Men and Women With Urologic Chronic Pelvic Pain Syndromes: Case-control Findings From the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network.
abstract: OBJECTIVE
  To determine the extent, severity, and sex differences of psychosocial deficits in men and women with urologic chronic pelvic pain syndromes (UCPPS), which in the past have been considered separate bladder (interstitial cystitis-painful bladder syndrome) and prostate (chronic prostatitis-chronic pelvic pain syndrome) disorders. Evaluations of men and women separately suggest UCPPS is associated with increased anxiety and depression. However, studies directly testing deficits in broader psychosocial domains such as cognitive processes, intimate relationships, and trauma history, or tests of sex differences in the pattern of difficulties associated with UCPPS have not been performed.
  
  
  METHODS
  A total of 233 female and 191 male UCPPS patients and 235 female and 182 male healthy controls (HCs) were recruited from 6 academic medical centers in the United States and evaluated with a comprehensive battery of symptom, psychosocial, and illness impact measures. Primary comparisons of interest were between UCPPS patients and HCs and between men and women with UCPPS.
  
  
  RESULTS
  In addition to greater negative effect, male and female UCPPS patients show higher levels of current and lifetime stress, poorer illness coping, increased self-report of cognitive deficits, and more widespread pain symptoms compared with sex- and education-matched HCs. Similar problems were found in male and female UCPPS patients although female UCPPS patients showed increased self-report of childhood adversity and more widespread symptoms of pain and discomfort.
  
  
  CONCLUSIONS
  Given the significance of psychosocial variables in prognosis and treatment of chronic pain conditions, the results add substantially to our understanding of the breath of difficulties associated with UCPPS and point to important areas for clinical assessment.
authors.affiliation: Department of Medicine, University of California, Los Angeles, Los Angeles, CA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA. Electronic address: naliboff@ucla.edu.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Naliboff
authors.affiliation: Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
authors.forename: Alisa J
authors.initials: AJ
authors.lastname: Stephens
authors.affiliation: Department of Psychiatry, University of California San Diego, San Diego, CA.
authors.forename: Niloo
authors.initials: N
authors.lastname: Afari
authors.affiliation: Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO.
authors.forename: Henry
authors.initials: H
authors.lastname: Lai
authors.affiliation: Department of Urology, University of Washington, Seattle, WA.
authors.forename: John N
authors.initials: JN
authors.lastname: Krieger
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO.
authors.forename: Barry
authors.initials: B
authors.lastname: Hong
authors.affiliation: Department of Urology, University of Iowa, Iowa City, IA.
authors.forename: Susan
authors.initials: S
authors.lastname: Lutgendorf
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, University of Washington, Seattle, WA.
authors.forename: Eric
authors.initials: E
authors.lastname: Strachan
authors.affiliation: Department of Anesthesiology, University of Michigan, Ann Arbor, MI; Department of Medicine, University of Michigan, Ann Arbor, MI.
authors.forename: David
authors.initials: D
authors.lastname: Williams
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D059350:Chronic Pain / Q000150:complications* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017699:Pelvic Pain / Q000150:complications* / Q000523:psychology*; D012720:Severity of Illness Index; D014570:Urologic Diseases / Q000150:complications* / Q000523:psychology; D055815:Young Adult