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Chronic pelvic pain as a somatoform disorder
U Ehlert1, C Heim, D H Hellhammer
1Center of Psychobiological and Psychosomatic Research, University of Trier, Germany. ehlertu@fpp.uni-trier.de
Psychotherapy and Psychosomatics
|February 23, 1999
Summary
Psychiatric factors like somatization and abuse are common in women with chronic pelvic pain, regardless of abdominal adhesions. These psychological elements appear to play a significant role in pain perception and persistence.
Area of Science:
- Gynecology
- Psychiatry
- Pain Medicine
Background:
- Idiopathic chronic pelvic pain (ICPP) is associated with psychiatric disturbances and life stressors.
- Investigating these factors in chronic pelvic pain with abdominal adhesions (ACPP) is crucial for understanding pain etiology.
Purpose of the Study:
- To compare psychiatric disturbances, somatization, and life events in women with ICPP versus ACPP.
- To determine if somatic pathology fully explains psychopathology in ACPP.
Main Methods:
- 40 women undergoing laparoscopy were grouped into ICPP (n=16), ACPP (n=10), and pain-free controls (n=14).
- Assessments included DSM-III-R diagnoses, depression, somatization, pain, abuse history, and critical life events via interviews and questionnaires.
Main Results:
- Somatoform pain disorder criteria met by 73.3% of ICPP and 60% of ACPP patients; controls had none.
- Both pain groups reported higher somatization and sexual abuse prevalence than controls.
- ACPP patients reported greater pain persistence than ICPP patients.
Conclusions:
- High somatization and abuse prevalence in both ICPP and ACPP suggest psychopathology is not solely explained by somatic factors.
- Psychological and experiential factors are significant in chronic pelvic pain, irrespective of adhesions.