Presentation Authors: Annie Chen*, Stony Brook, NY, Erin Crosby, Albany, NY, Elise De, Boston, MA
Introduction: Pelvic pain patients often have comorbid pain conditions. It is unclear exactly which patient factors contribute to the development of refractory chronic pain. However it has been shown that catastrophizing has a role. This study presents the phenotype of patients entering a comprehensive multidisciplinary pelvic pain center and elucidates characteristics associated with catastrophizing.
Methods: We launched a low capital virtual pelvic pain consortium in 2015 which diverts the majority of pelvic pain referrals across 11 specialties to a navigated program. All patients completed full histories, symptom screeners, and standardized questionnaires including the genitourinary pain index (GUPI), patient health questionnaire (PHQ-4) for anxiety and depression, interstitial cystitis symptom index (ICSI), pelvic floor distress inventory (PFDI-20). These scores, the number of comorbidities, and our simple intake screener were compared to the pain catastrophizing scale (PCS) by linear regression.
Results: 188 patients consented to research with mean age of 41.7. 23 were males. Mean scores were: GUPI 29.1, PHQ-4 anxiety 2.5 and depression 2.2, ICSI 7.7, and PFDI-20 102.5. Higher scores on GUPI (r2=34%, p < 0.001), PFD10 (r2=11%, p < 0.001), ICSI (r2=13%, p < 0.001), anxiety (r2=14%, p < 0.001), depression (r2=15%, p < 0.001) all had positive correlations with the PCS. Higher total number of pain co-morbidities by history correlated to the PCS (r2=11%, p < 0.001) as did higher affirmatives on our intake symptom screener (r2=12% p < 0.001). Mean of 4 comorbidities.
Conclusions: Higher scores on GUPI, PFD10, ICSI, and PHQ-4 standardized measures predict more catastrophizing in pelvic pain patients. These measures as well as elucidation of the number of pelvic symptoms and pain comorbidities helps identify patients with catastrophizing. It is important to recognize when pain extends beyond the bladder, engaging collaborators in a multidisciplinary approach, including counseling and other adjunctive therapies.