A feasibility trial of a cognitive-behavioural symptom management program for chronic pelvic pain for men with refractory chronic prostatitis/chronic pelvic pain syndrome

Abstract

Background: Our objective was to determine the feasibility of a cognitive behavioural symptom management program for the acute improvement of psychosocial risk factors of diminished quality of life (QoL) in men suffering from chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Materials and Methods:We assessed CP/CPPS symptoms and impact (i.e., chronic prostatitis symptom index [CPSI] pain, urinary, QoL domains), psychosocial risk factors were assessed at baseline and weekly for 8 weeks. We included the following psychosocial risk factors: catastrophizing (Pain Catastrophizing Scale, PCS), mood (Center for Epidemiological Studies in Depression Scale, CES-D), social support (Multidimensional Scale of Perceived Social Support, MSPSS) and general pain (McGill Pain Questionnaire). Patient sessions dispute and replace pessimistic thinking with health-focused thinking and behaviour. Results: Eleven men completed the psychosocial management program (mean age = 51.3, standard deviaton [SD] = 12.49). Mean CPSI baseline total score was 25.2 (SD = 10.21). Repeated measures ANOVAs showed the program was associated with significant linear reductions for pain (p = 0.051), disability (p= 0.020) and catastrophizing (p = 0.005), but no changes in depressive symptoms or social support. The CPSI baseline scores compared to follow-up scores (n = 8) were significantly reduced (p = 0.007), with CPSI pain (p = 0.015) and QoL impact (p = 0.013) reduced, but not for urinary scores. Correlations between change scores at the baseline and at 8 weeks for CPSI and psychosocial risk factors indicated that reductions in catastrophizing were most strongly associated with score reductions for the CPSI; these reductions, however, were not significant. Conclusions:The psychosocial management program targets and significantly reduces several empirically supported psychosocial risk factors associated with poorer CP/CPPS outcomes. Psychosocial management for CP/CPPS is feasible, but requires a randomized controlled trial with longitudinal follow-up.

Psychotherapy combined with drug therapy in patients with category III chronic prostatitis/chronic pelvic pain syndrome: A randomized controlled trial

“…Tripp et al confirmed that a psychological management program was potentially an effective and feasible management approach for men suffering with CP/CPPS. 30 These studies were consistent with the conclusions of our present study.…”

Disability in women suffering from interstitial cystitis/bladder pain syndrome

“…Recent feasibility research using a standardized psycho‐educational therapy with men suffering from chronic pelvic pain (i.e. chronic prostatitis) shows that significant reductions are possible in the areas of pain, patient disability and catastrophizing in as little as 8 weeks . Discussion of catastrophizing concerning pain and its ‘meaning’ to patients can be critical for improving patient management.…”

The development and delivery of a female chronic pelvic pain management programme: a specialised interdisciplinary approach

“…6,8,9 It has been suggested that psychologically based treatments can be effective in the management of CPP in addition to medical and surgical management. 10,11 Moreover, there has been recent publication in support of multidisciplinary CPP services, including a male CPP PMP: the LINK PMP. 12 In the context of the evidence of heightened levels of psychological distress and pain-related disabilities, a clear rationale can be seen for the provision of a PMP designed to support and pro-mote self-management strategies within this pain population.…”