Pain, catastrophizing, and depression in CP/CPPS

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Pain, catastrophizing, and depression in CP/CPPS

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Full article available here:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3713242/
Int Neurourol J. 2013 Jun;17(2):48-58. doi: 10.5213/inj.2013.17.2.48. Epub 2013 Jun 30.
Pain, catastrophizing, and depression in chronic prostatitis/chronic pelvic pain syndrome.

Kwon JK, Chang IH.
Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea.


Persistent and disabling pain is the hallmark of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, disease severity (as measured by objective indexes such as those that use radiography or serology) is only marginally related to patients' reports of pain severity, and pain-related presentation can differ widely among individuals with CP/CPPS. Increasing evidence in support of the biopsychosocial model of pain suggests that cognitive and emotional processes are crucial contributors to inter-individual differences in the perception and impact of pain. This review describes the growing body of literature relating depression and catastrophizing to the experience of pain and pain-related sequelae in CP/CPPS. Depression and catastrophizing are consistently associated with the reported severity of pain, sensitivity to pain, physical disability, poor treatment outcomes, and inflammatory disease activity and potentially with early mortality. A variety of pathways, from cognitive to behavioral to neurophysiological, seem to mediate these deleterious effects. Collectively, depression and catastrophizing are critically important variables in understanding the experience of pain in patients with CP/CPPS. Pain, depression, and catastrophizing might all be uniquely important therapeutic targets in the multimodal management of a range of such conditions.

PMID: 23869268
PMCID: PMC3713242
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Re: Pain, catastrophizing, and depression in CP/CPPS

Post by webslave »

World J Urol. 2013 Aug;31(4):733-9. doi: 10.1007/s00345-013-1067-6. Epub 2013 Apr 9.
A 2-year follow-up of quality of life, pain, and psychosocial factors in patients with chronic prostatitis/chronic pelvic pain syndrome and their spouses.
Tripp DA, Nickel JC, Shoskes D, Koljuskov A.
Departments of Psychology, Anesthesiology and Urology, Queen's University, Humphrey Hall, 62 Arch Street, Kingston, ON, K7L 3N6, Canada, [email protected].


OBJECTIVES: There are two objectives: (1) Examine quality of life (QoL) and mood between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) patients and spouses over a 2-year period; (2) Longitudinally assess CP/CPPS patient pain, disability, and pain catastrophizing over a 2-year period.

METHODS: Forty-four CP/CPPS diagnosed men and their spouses participated. Patients completed demographics, QoL, depression, anxiety, pain, disability, and catastrophizing across the study. Spouses completed QoL, depression, and anxiety. Patients/spouses were not different in education, but patients were older (49 years; SD = 9.56). The average symptom duration was 8.68 (SD = 7.61). Couples were married or common law, and majority of patients were employed. Due to attrition, approximately 21 couples provided analyzable data.

RESULTS: Patients and spouses physical QoL did not statistically differ over time from one another, and both increased over the study period. Mental QoL increased over time, but patients reported lower QoL. Patients reported more depression and anxiety, but both measures remained stable over time for spouses and patients. Finally, patient only analyses showed that disability did decrease over time from a high at 6 months, but pain and catastrophizing showed stability over the 2 years.

CONCLUSIONS: Patients reported worse mental QoL, depression, and anxiety compared to spouses, and spouses reported significant stable levels of depression and anxiety similar to patients. Further, patient catastrophizing, pain, and disability did not reduce over the 2-year assessment period. These results provide further impetus for the development and implementation of mental health strategies alongside continued medical efforts in couples suffering from CP/CPPS.

PMID: 23568443
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