Somatoform disorder as a predictor of interstitial cystitis/bladder pain syndrome

Abstract

Interstitial cystitis/bladder pain syndrome (IC/BPS) has several well-known comorbid psychiatric manifestations, including insomnia, anxiety, and depression. We hypothesized that somatoform disorder, which is a psychosomatic disease, can be used as a sensitive psychiatric phenotype of IC/BPS. We investigated whether somatoform disorder increases the risk of IC/BPS.A nested case-control study and a retrospective cohort study were followed up over a 12-year period (2002–2013) in the Taiwan Health Insurance Reimbursement Database. In the nested case-control study, 1612 patients with IC/BPS were matched in a 1:2 ratio to 3224 controls based on propensity scores. The odds ratio for somatoform disorder was calculated using conditional logistic regression analysis. In the retrospective cohort study, 1436 patients with somatoform disorder were matched in a 1:2 ratio to 2872 patients with nonsomatoform disorder based on propensity scores. Cox regression analysis was used to estimate the hazard ratio associated with the development of IC/BPS in patients with somatoform disorder, and the cumulative survival probability was tested using the Kaplan–Meier analysis.We found that the odds ratio for somatoform disorder was 2.46 (95% confidence interval [CI], 1.05–5.76). Although the average time until IC/BPS development in the control subjects was 11.5 ± 1.3 years, this interval was shorter in patients with somatoform disorder (6.3 ± 3.6 years). The hazard ratio for developing IC/BPS was 2.50 (95% CI 1.23–5.58); the adjusted hazard ratio was 2.26 (95% CI 1.002–5.007). The patients and controls also differed significantly in their cumulative survival probability for IC/BPS (log rank P < .05).Evidence from the nested case-control study and retrospective cohort study consistently indicated that somatoform disorder increases the risk for IC/BPS. Our study suggests that somatoform disorder can be used as a sensitive psychiatric phenotype to predict IC/BPS. Any past history of somatoform disorder should be documented while examining patients with IC/BPS.

Are psychological comorbidities important in the aetiology of lower urinary tract dysfunction—ICI‐RS 2018?

“…The authors conclude that somatoform disorder can be used as a sensitive psychiatric phenotype to predict IC/BPS. Any past history of somatoform disorder should be documented whilst examining patients with IC/BPS …”

“…Any past history of somatoform disorder should be documented whilst examining patients with IC/BPS. 34 Conversion disorder (or functional neurological symptom disorder) According to DSM-5, in functional neurological symptom disorder (FNSD) (the symptoms are sometimes referred to as "psychogenic" or "medically unexplained") there may be one or more symptoms of various types, for example, motor symptoms such as weakness or paralysis, abnormal movements such as tremor, sensory symptoms, nonepileptic seizures or episodes of syncope or coma. For diagnosis, there must be clinical findings that show clear evidence of incompatibility with neurological disease.…”

Genome-wide association study identifies risk loci within the major histocompatibility complex region for Hunner-type interstitial cystitis

“… 34 , 35 , 36 , 37 , 38 Meanwhile, other forms of IC/BPS, which lack Hunner lesions, are ill-defined, non-inflammatory conditions with little bladder pathology, characterized by central nervous sensitization and symptoms extending beyond the bladder, and are potentially associated with neurophysiological dysfunction and frequently accompanied by somatic and/or psychological symptoms. 39 , 40 , 41 , 42 , 43 , 44 Thus, HIC is a completely distinct inflammatory disease entity 4 , 45 , 46 and should be separated from the IC/BPS umbrella for clinical management and basic research purposes. 4 , 46 …”

Somatic symptoms in women with dysmenorrhea and noncyclic pelvic pain

“…Common NCPP conditions that have been shown to be associated with somatic symptoms include Irritable Bowel Syndrome (Koloski et al 2006) and Bladder Pain Syndrome/Interstitial Cystitis (Warren et al 2011; Lai et al 2012). In addition to somatic symptoms, anxiety and depression have also been shown to frequently co-occur in women with NCPP (Lorençatto et al 2006; Chung et al 2014a; Chen et al 2017b). These findings indicate that somatic symptoms may be a transdiagnostic risk factor that is observed across various pain conditions, including non-pelvic pain conditions such as temporomandibular joint disorder (Fillingim et al 2013), and lower back pain (Pincus et al 2002).…”