title: Depression and catastrophizing predict suicidal ideation in tertiary care patients with interstitial cystitis/bladder pain syndrome.
abstract: BACKGROUND
  We sought to evaluate psychosocial factors as predictors of suicidal ideation (SI) in a tertiary care outpatient sample of women suffering from interstitial cystitis/bladder pain syndrome (IC/BPS).
  
  
  METHODS
  The patients are women managed at tertiary care centres (n=190). Controls were recruited from the community (n=117). Both groups completed questionnaires on demographics, pain (McGill Pain Questionnaire), IC/BPS symptoms, and psychological variables. Univariate and multivariate hierarchical regression modelling was conducted to examine the strength of associations and unique effects of psychosocial variables on patient SI.
  
  
  RESULTS
  Compared to 6% in healthy controls, 23% of patients endorsed SI in the past two weeks. Correlations between SI, depression, and catastrophizing across controls and cases show that for controls, SI is associated with greater pain (0.31; p<0.01) and depression only (0.59; p<0.01). For tertiary care centre cases, SI is associated with pain (0.24; p<0.01), depression (0.64; p<0.01), and catastrophizing (0.35; p<0.01). Regression analyses indicated that psychosocial variables accounted for a significant amount of variance over and above IC/BPS symptoms. Catastrophizing (i.e., helplessness) about pain and depression were significant univariate predictors of SI, but only depression predicted SI in multivariable analyses.
  
  
  CONCLUSIONS
  Limitations of this study include its cross-sectional design and primarily correlation-based statistics. The present study is the first to implicate multiple psychosocial risk factors over and above IC/BPS-specific symptoms and patient pain experience in SI in women with IC/BPS. Depression in particular is uniquely important in predicting suicidality. These results support a multidisciplinary, proactive approach to IC/BPS involving not only treatment of disease symptoms, but also early detection/treatment of associated psychosocial problems.
authors.affiliation: Queen's University, Kingston, ON, Canada.
authors.forename: Dean A
authors.initials: DA
authors.lastname: Tripp
authors.affiliation: Queen's University, Kingston, ON, Canada.
authors.forename: J Curtis
authors.initials: JC
authors.lastname: Nickel
authors.affiliation: Queen's University, Kingston, ON, Canada.
authors.forename: Adrijana
authors.initials: A
authors.lastname: Krsmanovic
authors.affiliation: Temple University, Philadelphia, PA, United States.
authors.forename: Michel
authors.initials: M
authors.lastname: Pontari
authors.affiliation: Hofstra University School of Medicine, New Hyde Park, NY, United States.
authors.forename: Robert
authors.initials: R
authors.lastname: Moldwin
authors.affiliation: Asante Physician Partners, Grants Pass, OR, United States.
authors.forename: Robert
authors.initials: R
authors.lastname: Mayer
authors.affiliation: University of Toronto, Toronto, ON, Canada.
authors.forename: Lesley K
authors.initials: LK
authors.lastname: Carr
authors.affiliation: University of Washington, Seattle, WA, United States.
authors.forename: Claire C
authors.initials: CC
authors.lastname: Yang
authors.affiliation: University of Copenhagen, Herlev, Denmark.
authors.forename: Jorgen
authors.initials: J
authors.lastname: Nordling