Catastrophizing and coping behaviors determine mental quality of life for CPPS patients

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Caedar
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Catastrophizing and coping behaviors determine mental quality of life for CPPS patients

Post by Caedar »

Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)
INTRODUCTION: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent, chronic pelvic pain condition largely unresponsive to medical interventions. Psychosocial risk factors are associated with poor outcomes in CP/CPPS, but have not been examined for their intervening roles between pain and reduced quality of life (QoL). This study aimed to determine if psychosocial risk factors (i.e., patient coping and catastrophizing) mediate the association between pain and QoL.

METHODS: Using a cross sectional design, 175 men with CP/CPPS (mean age 46.83; SD 10.86) were recruited from tertiary care urology clinics and completed questionnaires on demographics, pain, QoL, pain coping, depression, and catastrophizing. An exploratory factor analysis was conducted and aggregate factor scores were examined to improve the amount of meaningful measurement to be used in multiple mediations. The models specified multiple risk factors as mechanisms between pain and both physical and mental QoL as the primary outcome measurements.

RESULTS: Four aggregate psychosocial factor scores were produced from the psychosocial measures (i.e., illness and wellness-focused behavioural coping, depression and catastrophizing). Illness-focused coping partially mediated the relationship between pain and physical QoL. However, catastrophizing and illness-focused coping fully mediated the relation between pain and mental QoL, showing the association between pain and mental QoL was no longer significant when catastrophizing and illness-focused coping were in the model.

CONCLUSION: Psychosocial factors function as mechanisms between higher pain and they are associated diminished mental QoL. These results introduce illness-focused coping as an important biopsychosocial target in CP/CPPS management.
This is more evidence that it's absolutely essential to get a handle on catastrophizing and bad coping behaviors. Essentially, what this study says is that the CPPS pain itself doesn't decrease mental quality of life; if you can control catastrophizing and coping, you can negate the pain's effect on your mental quality of life. Catastrophizing leads to a downward spiral, but reducing catastrophizing leads to an upwart spiral. Keep it up, everyone!

Maybe Dr. Shoskes can tell us some more about the results of this study if he sees this post. :-D
Age: 26 | Onset Age: 23 | Symptoms: Neuropathic-like pain and hyperalgesia (lateral/anterior thighs mostly, but distributed throughout body); Pain (penis shaft, right side, when erect for long or excess masturbation) | Previous Symptoms: Pain (testicles; penis underside, mostly near base and running up urethra, sharp/burning; perennial region, dull; ejaculatory; post-ejaculatory); Urinary (moderate incomplete voiding; moderate frequency and pain on bladder filling); Sensations (cold in head of penis) | Helped By: Stretching (especially hip rotators and flexors); Yoga (especially lunges, warrior 2, and pigeon) Trigger point release (abdominals; iliopsoas; gluteus muscles and piriformis; bulbospongiosus & ischiocavernosus; thigh adductors); Meditation (mindfulness); Walking & Aerobic Exercise | Worsened By: Stress, anxiety, too much alcohol, lack of sleep, sitting at length | Current prescriptions: nortriptyline (10 mg, 1x at night; for CNS sensitization and IBS) Previous prescriptions: hydroxyzine (10 mg, 1x at night; for urinary symptoms/mast cell stabilization; useful), clonazepam (0.25-0.5 mg, 1x at night; for anxiety/CNS sensitization; useful for short time)
European
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Re: Catastrophizing and coping behaviors determine mental quality of life for CPPS patients

Post by European »

Sure, catastrophizing is one of the most challenging aspects of long term CPPS. It is not easy to find coping strategies because I think it is only a matter of time when, during a bad flare-up, you are overwhelmed by feelings of guilt, helplessness and hopelessness. I get the feeling that you cannot beat those feelings completely, but sure after time passes, your mind will recover a bit. Cognitive behavioral strategies are not strong enough to escape from that situation. Caedar, when I am reading description of your status, it is almost same as my case..almost exactly.
Age: 41 | Onset Age: 36 | Symptoms: Chronic pain in the penis, groin, pubic area and pelvic muscles, mainly ischiocavernosus area | Helped By: Elavil, PT | Worsened By: Stress, ejaculation, depression | Other comments:
resianam
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Re: Catastrophizing and coping behaviors determine mental quality of life for CPPS patients

Post by resianam »

I'm bad with catastrophizing. It's challenging to overcome because you don't get to practice coping techniques. It could be months or years between episodes. You learn your lessons and then forget them before the next one shows up, suddenly and unannounced. It's not really amenable to treatment.
Age: 34 | Onset Age: 20s | Symptoms: Pelvic pain | Helped By: Abstinence | Worsened By: Sex | Other comments:
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