Associations between chronic pelvic pain and psychiatric disorders and symptoms

Background Chronic pelvic pain (CPP) is a complex condition wich is associated with emotional factors, specially depression and anxiety. Objectives To make a systematic review to provide a detailed summary of relevant literature on the association between CPP and different psychiatric disorders/symptoms. Methods A systematic review of articles in the international literature published between 2003 and 2014 was performed in the electronic databases PubMed, PsycINFO, LILACS, and SciELO using the terms (chronic pelvic pain) AND (psychiatry OR psychiatric OR depression OR anxiety OR posttraumatic stress OR somatoform). The searches returned a total of 529 matches that were filtered according to predefined inclusion and exclusion criteria. A total of 18 articles were selected. Results The investigations focused mainly on the assessment of depression and anxiety disorders/symptoms, with rather high rates (17-38.6%). Depression and anxiety symptoms were more prevalent among women with CPP compared to healthy groups. Comparisons between groups with CPP and with specific pathologies that also have pain as a symptom showed that depression indicators are more frequent in CPP. Depressive symptoms tend to be more common in CPP and have no particular association with pain itself, the core feature of CPP. Discussion Other aspects of CPP seem to play a specific role in this association. Anxiety and other psychiatric disorders require further investigation so that their impact on CPP can be better understood.

【背景】慢性盆腔痛（chronic pelvic pain, CPP）是一类复杂病症，其发生与情绪因素密切相关，尤以抑郁与焦虑最为突出。
【目的】本研究旨在开展一项系统综述，对探讨CPP与各类精神障碍/精神症状之间关联的相关文献进行全面梳理与总结。
【方法】本研究针对2003年至2014年间发表的国际文献开展系统综述，检索了PubMed、PsycINFO、LILACS及SciELO四大电子数据库，检索式为：(慢性盆腔痛) AND (精神病学 OR 精神障碍相关 OR 抑郁 OR 焦虑 OR 创伤后应激 OR 躯体形式障碍)。本次检索共获得529条结果，随后根据预先设定的纳入与排除标准进行筛选，最终纳入18篇文献。
【结果】现有研究主要聚焦于抑郁与焦虑障碍/症状的评估，相关检出率较高（17%~38.6%）。与健康人群相比，CPP女性患者的抑郁与焦虑症状检出率更高。将CPP患者与以疼痛为主要临床表现的其他特定疾病患者进行对照分析后发现，CPP人群的抑郁相关指标检出频率更高。抑郁症状在CPP患者中更为普遍，且与CPP的核心特征——疼痛本身并无显著关联。
【讨论】CPP的其他相关特征似乎在这一关联中扮演着特定角色。焦虑及其他精神障碍与CPP的具体关联及影响机制仍需进一步深入研究，以便更清晰地阐明其对CPP的作用。