A feasibility trial of a cognitive-behavioural symptom management program for chronic pelvic pain for men with refractory chronic prostatitis/chronic pelvic pain syndrome
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Background: Our objective was to determine the feasibility of acognitive behavioural symptom management program for the acuteimprovement of psychosocial risk factors of diminished quality oflife (QoL) in men suffering from chronic prostatitis/chronic pelvicpain syndrome (CP/CPPS).Materials and Methods: We assessed CP/CPPS symptoms andimpact (i.e., chronic prostatitis symptom index [CPSI] pain, urinary,QoL domains), psychosocial risk factors were assessed at baselineand weekly for 8 weeks. We included the following psychosocialrisk factors: catastrophizing (Pain Catastrophizing Scale, PCS),mood (Center for Epidemiological Studies in Depression Scale,CES-D), social support (Multidimensional Scale of Perceived SocialSupport, MSPSS) and general pain (McGill Pain Questionnaire).Patient sessions dispute and replace pessimistic thinking withhealth-focused thinking and behaviour.Results: Eleven men completed the psychosocial management program(mean age = 51.3, standard deviaton [SD] = 12.49). MeanCPSI baseline total score was 25.2 (SD = 10.21). Repeated measuresANOVAs showed the program was associated with significantlinear reductions for pain (p = 0.051), disability (p= 0.020)and catastrophizing (p = 0.005), but no changes in depressivesymptoms or social support. The CPSI baseline scores comparedto follow-up scores (n = 8) were significantly reduced (p = 0.007),with CPSI pain (p = 0.015) and QoL impact (p = 0.013) reduced,but not for urinary scores. Correlations between change scores atthe baseline and at 8 weeks for CPSI and psychosocial risk factorsindicated that reductions in catastrophizing were most stronglyassociated with score reductions for the CPSI; these reductions,however, were not significant.Conclusions: The psychosocial management program targets andsignificantly reduces several empirically supported psychosocialrisk factors associated with poorer CP/CPPS outcomes. Psychosocialmanagement for CP/CPPS is feasible, but requires a randomizedcontrolled trial with longitudinal follow-up.
