This pain drives me crazy: Psychiatric symptoms in women with interstitial cystitis/bladder pain syndrome

doi:10.5498/wjp.v14.i6.954

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World Journal of Psychiatry

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World J Psychiatry. Jun 19, 2024; 14(6): 954-984
Published online Jun 19, 2024. doi: 10.5498/wjp.v14.i6.954

This pain drives me crazy: Psychiatric symptoms in women with interstitial cystitis/bladder pain syndrome

Marianna Mazza, Stella Margoni, Giuseppe Mandracchia, Guglielmo Donofrio, Alessia Fischetti, Georgios D Kotzalidis, Giuseppe Marano, Alessio Simonetti, Delfina Janiri, Lorenzo Moccia, Gabriele Sani, Giovanni Scambia, Antonio Gasbarrini, Daniela Chieffo, Giovanni Camardese, Laura Monti, Giulia Battisti, Arianna Crupi, Flavio Tavoletta, Andrea Zanzarri, Gianmarco Stella, Emanuela De Chiara, Francesca Bardi, Elettra Specogna, Sara Barbonetti, Monia Marturano, Eleonora Gaetani, Mariateresa Acanfora, Leonardo Monacelli, Luca Chisari, Luca Onori, Francesco Traccis, Francesco Pesaresi, Romina Caso, Luca Di Benedetto, Elisabetta Benini, Giulia Mastroeni, Luca Lo Giudice, Sara Ruggiero, Marco Biscosi, Giovanni Bartolucci, Miriam Milintenda, Alberto Torresi, Anna Quintano, Cecilia Falsini, Maria Benedetta Anesini, Gianluca Boggio, Francesca Abate, Ester Maria Marzo, Valeria De Masi, Maria Chiara Spera, Sara Rossi, Andrea Brugnami, Michele Ciliberto, Claudia Calderoni, Flavia Grisoni, Caterina Brisi, Antonio Maria D'Onofrio, Francesco Maria Lisci, Antonio Restaino, Evelina Bernardi, Ottavia Ferrara, Domenico De Berardis, Greta Sfratta, Ilaria Marcelli

Marianna Mazza, Giuseppe Marano, Department of Neurosciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy

Stella Margoni, Giuseppe Mandracchia, Guglielmo Donofrio, Alessia Fischetti, Georgios D Kotzalidis, Alessio Simonetti, Delfina Janiri, Ilaria Marcelli, Greta Sfratta, Ottavia Ferrara, Evelina Bernardi, Antonio Restaino, Francesco Maria Lisci, Antonio Maria D'Onofrio, Caterina Brisi, Flavia Grisoni, Claudia Calderoni, Michele Ciliberto, Andrea Brugnami, Sara Rossi, Maria Chiara Spera, Valeria De Masi, Ester Maria Marzo, Francesca Abate, Gianluca Boggio, Maria Benedetta Anesini, Cecilia Falsini, Anna Quintano, Alberto Torresi, Miriam Milintenda, Giovanni Bartolucci, Marco Biscosi, Sara Ruggiero, Luca Lo Giudice, Giulia Mastroeni, Elisabetta Benini, Luca Di Benedetto, Romina Caso, Francesco Pesaresi, Francesco Traccis, Luca Onori, Luca Chisari, Leonardo Monacelli, Mariateresa Acanfora, Sara Barbonetti, Elettra Specogna, Francesca Bardi, Emanuela De Chiara, Gianmarco Stella, Andrea Zanzarri, Flavio Tavoletta, Arianna Crupi, Giulia Battisti, Giovanni Camardese, Department of Psychiatry, Università Cattolica del Sacro Cuore, Rome 00168, Italy

Lorenzo Moccia, Department of Neurosciences, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy

Domenico De Berardis, Mental Health, NHS, ASL 4 Teramo, Teramo 64100, Italy

Eleonora Gaetani, Medical and Surgical Sciences, Università Cattolica del Sacro Cuore, Rome 00168, Italy

Monia Marturano, Division of Gynecologic Oncology, Università Cattolica del Sacro Cuore, Rome 00168, Italy

Laura Monti, Daniela Chieffo, UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy

Antonio Gasbarrini, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome 00168, Italy

Giovanni Scambia, Department of Woman and Child Health, Catholic University, Rome 00168, Italy

Gabriele Sani, UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy

Author contributions: Mazza M, Margoni S, Mandracchia G, Donofrio G, Fischetti A, Kotzalidis GD, Marano G, Simonetti A, Janiri D, Moccia L, Marcelli I, Sfratta G, De Berardis D, Ferrara O, Bernardi E, Restaino A, Lisci FM, D'Onofrio AM, Brisi C, Grisoni F, Calderoni C, Ciliberto M, Brugnami A, Rossi S, Spera MC, De Masi V, Marzo EM, Abate F, Boggio G, Anesini MB, Falsini C, Quintano A, Torresi A, Milintenda M, Bartolucci G, Biscosi M, Ruggiero S, Lo Giudice L, Mastroeni G, Benini E, Di Benedetto L, Caso R, Pesaresi F, Traccis F, Onori L, Chisari L, Monacelli L, Acanfora M, Gaetani E, Marturano M, Barbonetti S, Specogna E, Bardi F, De Chiara E, Stella S, Zanzarri A, Tavoletta F, Crupi A, Battisti G, Monti L, Camardese G, Chieffo D, Gasbarrini A, Scambia G, and Sani G conceived the review, designed it, discussed the details in Delphi rounds where consensus was reached, implemented searches, identified eligible articles, retrieved and analysed data in the articles, interpreted them, contributed substantially in drafting the paper, providing original ideas for further discussion, provided the final draft and agreed upon its final version; All authors read and approved the current version.

Conflict-of-interest statement: All authors declare having no conflicts of interest.

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Corresponding author: Marianna Mazza, MD, PhD, Assistant Professor, Department of Neurosciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo A Gemelli 8, Rome 00168, Italy.mariannamazza@hotmail.com

Received: February 28, 2024
Revised: April 22, 2024
Accepted: May 7, 2024
Published online: June 19, 2024
Processing time: 112 Days and 1.9 Hours

Abstract

BACKGROUND

Interstitial cystitis/bladder pain syndrome (IC/BPS) is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic, abdominal, and/or pelvic pain. Although the term cystitis suggests an inflammatory or infectious origin, no definite cause has been identified. It occurs in both sexes, but women are twice as much affected.

AIM

To systematically review evidence of psychiatric/psychological changes in persons with IC/BPS.

METHODS

Hypothesizing that particular psychological characteristics could underpin IC/BPS, we investigated in three databases the presence of psychiatric symptoms and/or disorders and/or psychological characteristics in patients with IC/BPS using the following strategy: ("interstitial cystitis" OR "bladder pain syndrome") AND ("mood disorder" OR depressive OR antidepressant OR depression OR depressed OR hyperthymic OR mania OR manic OR rapid cycl^asterisk OR dysthymi^asterisk OR dysphori^asterisk).

RESULTS

On September 27, 2023, the PubMed search produced 223 articles, CINAHL 62, and the combined PsycLIT/ PsycARTICLES/PsycINFO/Psychology and Behavioral Sciences Collection search 36. Search on ClinicalTrials.gov produced 14 studies, of which none had available data. Eligible were peer-reviewed articles reporting psychiatric/psychological symptoms in patients with IC/BPS, i.e. 63 articles spanning from 2000 to October 2023. These studies identified depression and anxiety problems in the IC/BPS population, along with sleep problems and the tendency to catastrophizing.

CONCLUSION

Psychotherapies targeting catastrophizing and life stress emotional awareness and expression reduced perceived pain in women with IC/BPS. Such concepts should be considered when implementing treatments aimed at reducing IC/BPS-related pain.

Keywords: Interstitial cystitis/bladder pain syndrome; Psychiatric symptoms; Psychological symptoms; Catastrophizing; Anxiety; Depression

Core Tip: Interstitial cystitis/bladder pain syndrome (IC/BPS) occurs in 2%-18% of the general population, most commonly in women and in people having first-degree relatives affected by the same syndrome. Despite its name suggesting that an inflammation could be involved, no inflammatory aetiology has been found to date. The syndrome causes major sufferance in affected patients and may even affect their psychological status. In spite of efforts to resolve it, no treatment currently exists. Catastrophizing is all too often present in pain syndromes and may be targeted by psychotherapy to reduce the impact of IC/BPS in affected people.