Chronic pelvic pain patients demonstrate higher catastrophizing in association with pelvic symptoms and comorbid pain diagnoses.

To elucidate the relationship between catastrophization and pelvic pain symptomatology in chronic pelvic pain (CPP) patients using standardized questionnaires.

CPP patients completed standardized questionnaires which included: genitourinary pain index (GUPI), patient health questionnaire (PHQ-4) for anxiety and depression, interstitial cystitis symptom index (ICSI), and pelvic floor distress inventory (PFDI-20). Scores and number of comorbidities were compared to Pain Catastrophizing Scale (PCS) by linear regression. Patients categorized as "extreme catastrophizing" (PCS score ≥30), traditionally associated with worse outcomes in the pain literature [10-11], were also analyzed separately.

184 patients were included (mean age 42 years, N=23 male). Higher number of pain comorbidities was correlated to PCS (p<0.001) as well as higher scores on all standardized questionnaires (p<0.001). Forty-four percent of patients (81/184) were extreme catastrophizers and scored significantly worse on all standardized measures when compared to non-extreme catastrophizers. Mean scores for non-extreme versus extreme catastrophizers were: GUPI (25.7±6.8 vs. 32.7±6.5, p<0.001), ICSI (6.5±4.7 vs. 9.4±5.8, p<0.001), PFDI (88.8±52 vs. 121.1±62.8, p<0.001), PHQ4 anxiety (1.7±2.0 vs. 3.6±=2.1, p<0.001) and depression (1.4±1.6 vs. 3.3±2.0, p<0.001). Number of comorbidities was not significant predictor of extreme catastrophizing (3.5 vs. 3.7 p=0.22).

Higher scores on standardized questionnaires and more comorbidities was associated with more catastrophizing in CPP patients. This study highlights the significance of standardized questionnaires, including the PCS, to predict which patients may be extreme catastrophizers and thus subject to worse outcomes. Future studies are needed to look at catastrophization as a potentially modifiable and treatable risk factor.

Urology. 2020 Jul 12 [Epub ahead of print]

Annie Chen, Charles Argoff, Erin Crosby, Elise Jb De

Stony Brook University Hospital, Stony Brook Medicine HSC T9 Room 040, Stony Brook, NY 11794. Electronic address: ., Albany Medical Center, Professor of Neurology at Albany Medical College and Director of the Comprehensive Pain Center at Albany Medical Center., Albany Medical Center, Assistant Professor of Obstetrics and Gynecology., Massachusetts General Hospital, Department of Urology, 165 Cambridge St 7th Floor, Boston, MA 02114 (p) 857-238-3838, (f) 617-726-6131. Electronic address: .

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