Disability in women suffering from interstitial cystitis/bladder pain syndrome

OBJECTIVES: To examine a biopsychosocial framework of patient disability in patients suffering from interstitial cystitis/bladder pain syndrome (IC/BPS). To evaluate the impact of psychosocial factors on the relationship between pain and disability within women with IC/BPS. PATIENTS AND METHODS: Women with IC/BPS completed questionnaires including demographics, symptoms and problems (IC Symptom and Problem Indices), pain (McGill Pain Questionnaire), quality of life (Medical Outcomes Study - Short Form 12), disability (Pain Disability Index) and psychosocial variables (Center for Epidemiological Studies - Depression Scale; State Trait Anxiety Inventory; Pain Catastrophizing Scale; Multidimensional Scale of Perceived Social Support). Exploratory and confirmatory factor analyses were employed to determine the factor structure and composition of the measured variables. Structural equation modelling was used to examine model fit and the mediation effect of the psychosocial factors (negative affect, catastrophizing and social support) on impairments and functional disability. RESULTS: Questionnaires completed by 196 women with IC/BPS provided data for the present study. The measurement model showed good fit to the data. Negative affect (P < 0.001) and catastrophizing (P < 0.001) were significant in explaining the relationship between impairments and functional disability, whereas social support did not. CONCLUSIONS: Disability in patients suffering from IC/BPS is partially explained by the impact of negative affect and catastrophizing. As a result of the refractory nature of IC/BPS, patient management within a biopsychosocial framework represents an essential area of investigation. Decreases in negative affect and catastrophizing will probably lead to improvements in pain-related disability.