Psychological distress in twins with urological symptoms☆
Received 5 October 2009; accepted 19 January 2010. published online 22 February 2010.
Abstract
Objective
Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic pain condition with unclear underlying etiology. Our objectives were to determine whether psychological distress was higher in twins with urological symptoms commonly found in IC/PBS than in twins without, and if so, did familial influences contribute to this association.
Method
Data from 1165 female twins in a community-based sample were used. Urological symptoms, symptoms of posttraumatic stress disorder (PTSD), depression, anxiety and perceived stress were assessed with standardized questionnaires. Generalized estimating equation (GEE) regression models were used to examine the relationship between psychological distress and urological symptoms.
Results
Compared to unaffected twins, twins with urological symptoms were more likely to report PTSD symptoms (OR=3.9; 95% CI=2.6–5.8), depression (OR=3.1; 95% CI=2.0–5.0), anxiety (OR=3.4; 95% CI=2.3–5.2) and perceived stress (OR=3.2; 95% CI=2.1–4.9). After adjusting for familial influences, the within-pair effects remained significant for PTSD symptoms (OR=2.2; 95% CI=1.2–3.8) and perceived stress (OR=2.2; 95% CI=1.2–3.8).
Conclusion
Familial influences partially explained the relationship between indicators of psychological distress and urological symptoms. Future research should examine shared environmental and genetic mechanisms that may further explain this relationship and improve diagnosis and treatment of this unexplained clinical condition.
aDepartment of Psychiatry, University of California, San Diego, La Jolla, CA 92093-0738, USA
bDepartment of Medicine, University of Washington, Seattle, WA 98101, USA
cDepartment of Psychology, University Rey Juan Carlos, Madrid 28922, Spain
dVeterans Affairs San Diego Healthcare System and Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, CA 92161, USA
Corresponding author. Department of Psychiatry, University of California, San Diego, Mail Code 0738, La Jolla, CA 92093-0738, USA. Tel.: +1 858 534 2670; fax: +1 858 822 3777.
☆ This research was supported by National Institutes of Health awards R01AR051524 (Dr. Afari) and U01 DK082325 (Drs. Buchwald and Afari). Dr. Afari is also supported by the VA Center of Excellence for Stress and Mental Health. Dr. Johnson Wright is supported in part by R01AR051524. A portion of this research was presented at the 28th Annual American Pain Society meeting in San Diego, CA, USA.
ABSTRACT