Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

doi:10.5489/cuaj.2179

. 2014 Nov;8(11-12):403-8.

doi: 10.5489/cuaj.2179.

Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

Adrijana Krsmanovic¹, Dean A Tripp², J Curtis Nickel³, Daniel A Shoskes⁴, Michel Pontari⁵, Mark S Litwin⁶, Mary F McNaughton-Collins⁷

Affiliations

¹ Psychology, Queen's University, Kingston, ON;
² Psychology, Anesthesiology and Urology, Queen's University, Kingston, ON;
³ Urology, Queen's University, Kingston, ON;
⁴ Urology, Glickman Urological and Kidney Institute, Cleveland, Ohio;
⁵ Urology, Temple University, Philadelphia, PA;
⁶ Urology, David Geffen School of Medicine at UCLA, Los Angeles, California and Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California;
⁷ Massachusetts General Hospital, Boston, Massachusetts.

PMID: 25553153
PMCID: PMC4277519
DOI: 10.5489/cuaj.2179

Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

Adrijana Krsmanovic et al. Can Urol Assoc J. 2014 Nov.

. 2014 Nov;8(11-12):403-8.

doi: 10.5489/cuaj.2179.

Authors

Adrijana Krsmanovic¹, Dean A Tripp², J Curtis Nickel³, Daniel A Shoskes⁴, Michel Pontari⁵, Mark S Litwin⁶, Mary F McNaughton-Collins⁷

Affiliations

¹ Psychology, Queen's University, Kingston, ON;
² Psychology, Anesthesiology and Urology, Queen's University, Kingston, ON;
³ Urology, Queen's University, Kingston, ON;
⁴ Urology, Glickman Urological and Kidney Institute, Cleveland, Ohio;
⁵ Urology, Temple University, Philadelphia, PA;
⁶ Urology, David Geffen School of Medicine at UCLA, Los Angeles, California and Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California;
⁷ Massachusetts General Hospital, Boston, Massachusetts.

PMID: 25553153
PMCID: PMC4277519
DOI: 10.5489/cuaj.2179

Abstract

Introduction: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent, chronic pelvic pain condition largely unresponsive to medical interventions. Psychosocial risk factors are associated with poor outcomes in CP/CPPS, but have not been examined for their intervening roles between pain and reduced quality of life (QoL). This study aimed to determine if psychosocial risk factors (i.e., patient coping and catastrophizing) mediate the association between pain and QoL.

Methods: Using a cross sectional design, 175 men with CP/CPPS (mean age 46.83; SD 10.86) were recruited from tertiary care urology clinics and completed questionnaires on demographics, pain, QoL, pain coping, depression, and catastrophizing. An exploratory factor analysis was conducted and aggregate factor scores were examined to improve the amount of meaningful measurement to be used in multiple mediations. The models specified multiple risk factors as mechanisms between pain and both physical and mental QoL as the primary outcome measurements.

Results: Four aggregate psychosocial factor scores were produced from the psychosocial measures (i.e., illness and wellness-focused behavioural coping, depression and catastrophizing). Illness-focused coping partially mediated the relationship between pain and physical QoL. However, catastrophizing and illness-focused coping fully mediated the relation between pain and mental QoL, showing the association between pain and mental QoL was no longer significant when catastrophizing and illness-focused coping were in the model.

Conclusion: Psychosocial factors function as mechanisms between higher pain and they are associated diminished mental QoL. These results introduce illness-focused coping as an important biopsychosocial target in CP/CPPS management.

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Figures

**Fig. 1**
Multiple Mediation Model for Physical Quality of Life. Standardized regression coefficients (β) for the relationship between pain and physical quality of life, as mediated by psychosocial variables. ^**p < 0.01.

**Fig. 2**
Multiple Mediation Model for Mental Quality of Life. Standardized regression coefficients (β) for the relationship between pain and mental quality of life, as mediated by psychosocial variables. ^*p < 0.05, ^**p < 0.01.

See this image and copyright information in PMC

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References

1. Krieger JN, Egan KJ, Ross SO, et al. Chronic pelvic pains represent the most prominent urogenital symptoms of “chronic prostatitis”. J Urol. 1996;48:715–22. doi: 10.1016/S0090-4295(96)00421-9. - DOI - PubMed
1. Habermacher GM, Chason JT, Schaeffer AJ. Prostatitis/chronic pelvic pain syndrome. Annu Rev Med. 2006;57:195–206. doi: 10.1146/annurev.med.57.011205.135654. - DOI - PubMed
1. McNaughton-Collins M, Stafford RS, O’Leary MP, et al. How common is prostatitis? A national survey of physician visits. J Urol. 1998;159:1224–8. doi: 10.1016/S0022-5347(01)63564-X. - DOI - PubMed
1. Krieger JN, Riley DE, Cheah PY, et al. Epidemiology of prostatitis: New evidence for a world-wide problem. World J Urol. 2003;21:70–4. doi: 10.1007/s00345-003-0329-0. - DOI - PubMed
1. Tripp DA, Nickel JC, Ross S, et al. Prevalence, symptom impact and predictors of chronic prostatitis-like symptoms in Canadian males aged 16–19 years. BJU Int. 2008;103:1080–4. - PubMed

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[1] Krieger JN, Egan KJ, Ross SO, et al. Chronic pelvic pains represent the most prominent urogenital symptoms of “chronic prostatitis”. J Urol. 1996;48:715–22. doi: 10.1016/S0090-4295(96)00421-9. - DOI - PubMed

[2] Krieger JN, Egan KJ, Ross SO, et al. Chronic pelvic pains represent the most prominent urogenital symptoms of “chronic prostatitis”. J Urol. 1996;48:715–22. doi: 10.1016/S0090-4295(96)00421-9. - DOI - PubMed

[3] Habermacher GM, Chason JT, Schaeffer AJ. Prostatitis/chronic pelvic pain syndrome. Annu Rev Med. 2006;57:195–206. doi: 10.1146/annurev.med.57.011205.135654. - DOI - PubMed

[4] Habermacher GM, Chason JT, Schaeffer AJ. Prostatitis/chronic pelvic pain syndrome. Annu Rev Med. 2006;57:195–206. doi: 10.1146/annurev.med.57.011205.135654. - DOI - PubMed

[5] McNaughton-Collins M, Stafford RS, O’Leary MP, et al. How common is prostatitis? A national survey of physician visits. J Urol. 1998;159:1224–8. doi: 10.1016/S0022-5347(01)63564-X. - DOI - PubMed

[6] McNaughton-Collins M, Stafford RS, O’Leary MP, et al. How common is prostatitis? A national survey of physician visits. J Urol. 1998;159:1224–8. doi: 10.1016/S0022-5347(01)63564-X. - DOI - PubMed

[7] Krieger JN, Riley DE, Cheah PY, et al. Epidemiology of prostatitis: New evidence for a world-wide problem. World J Urol. 2003;21:70–4. doi: 10.1007/s00345-003-0329-0. - DOI - PubMed

[8] Krieger JN, Riley DE, Cheah PY, et al. Epidemiology of prostatitis: New evidence for a world-wide problem. World J Urol. 2003;21:70–4. doi: 10.1007/s00345-003-0329-0. - DOI - PubMed

[9] Tripp DA, Nickel JC, Ross S, et al. Prevalence, symptom impact and predictors of chronic prostatitis-like symptoms in Canadian males aged 16–19 years. BJU Int. 2008;103:1080–4. - PubMed

[10] Tripp DA, Nickel JC, Ross S, et al. Prevalence, symptom impact and predictors of chronic prostatitis-like symptoms in Canadian males aged 16–19 years. BJU Int. 2008;103:1080–4. - PubMed

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Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

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Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

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