Cognition, Emotion, and the Bladder: Psychosocial Factors in Bladder Pain Syndrome and Interstitial Cystitis (BPS/IC)

Purpose of Review To review findings from empirical studies assessing the role of psychosocial factors in bladder pain syndrome and interstitial cystitis (BPS/IC). Recent Findings There is a high rate of psychosocial comorbidity in BPS/IC, including elevated levels of anxiety and depression. Recent studies assessing the role of illness perceptions in BPS/IC relate poorer illness perceptions to more unhelpful illness coping patterns. Conversely, positive illness perceptions including self-efficacy in illness management are associated with more adaptive coping behaviors such as exercising and acceptance. New research is investigating the role of trauma in BPS/IC and the impact of suicidality. There is a paucity of psychosocial interventions for BPS/IC over the last 5 years. The three small-scale studies reviewed included a mindfulness-based stress reduction (MBSR) intervention tailored for BPS/IC, a brief self-management intervention designed to increase patient knowledge and symptom management techniques and a 90-min interview aimed at increasing awareness about physiological affective relationship in IC. Illness-related cognitions impact illness-related coping behavior, distress, symptom severity, and QoL in BPS/IC. Positive illness perceptions can positively impact behavioral responses to illness and illness outcomes. Trauma, emotion regulation, and suicidality in BPS/IC are important factors for psychosocial interventions and multidisciplinary treatments to address. Insight from the existing evidence base and other functional illness areas such as IBS can be used to inform the design and assessment of interventions aimed to understand and treat BPS/IC as a biopsychosocial illness. The role of healthcare practitioners is fundamental to informing patient perceptions of their illness and providing adequate support for their own self-management approaches.