optimizing psychosocial treatment of interstitial cystitis/bladder pain syndrome

Conditions: Chronic Interstitial Cystitis; Bladder Pain Syndrome; Cystitis, Interstitial; Painful Bladder Syndrome; Cystitis, Chronic Interstitial; Interstitial Cystitis; Interstitial Cystitis, Chronic; Interstitial Cystitis (Chronic) With Hematuria; Interstitial Cystitis (Chronic) Without Hematuria; Chronic Prostatitis; Chronic Prostatitis With Chronic Pelvic Pain Syndrome

Summary: interstitial cystitis/bladder pain syndrome (ic/bps) is a severe pain condition affecting 3-8 million people in the united states lacking treatments that work. emotional suffering is common in ic/bps and known to make physical symptoms worse, and studies show patient sub-groups respond differently to treatment. by creating and testing a psychosocial intervention specific to ic/bps, we will learn if this intervention improves patient wellness, who the intervention works best for, and how the body's pain processing influences outcomes.

interstitial cystitis/bladder pain syndrome (ic/bps) is a debilitating, incurable, and costly pain condition affecting approximately 3-8 million individuals in the united states and is extremely challenging to treat. evidence suggests psychosocial factors accompany and intensify the illness. unaddressed psychosocial co-morbidities are associated with reduced functionality and poorer outcomes, which suggests that psychosocial symptoms and bladder-specific symptoms reinforce each other. while psychosocial self-management interventions have demonstrated efficacy for other pain conditions, the ic/bps field lacks the gold standard - randomized controlled trials - studying these interventions. at the same time, the chronic pain field is adopting a new approach driven by mechanisms of illness and treatment. growing evidence suggests that subgroups (called "phenotypes") of patients with ic/bps respond differently to medical intervention. presence of central sensitization (cs) largely defines patient subgroups and may be a biological factor affecting response to medical treatment. the overall goal of this project is to fully develop, optimize, and evaluate a patient-centered cbt self-management intervention specific to ic/bps. to achieve this goal, we will develop (aim 1) and test (aim 2) an empirically-based psychosocial treatment for ic/bps compared to attention control, while examining pain mechanisms and subgroup characteristics that may alter treatment response (aim 3). we hypothesize that a) inclusion of a self-management intervention will be more effective than a control treatment for ic/bps, and that b) treatment effects will be moderated by degree of psychological co-morbidity, presence of chronic overlapping pain conditions, and elevated central sensitization. successful completion of these aims will determine whether the addition of a tailored self-management intervention for ic/bps will improve outcomes compared to control, whether particular subgroups are more responsive to this intervention, and whether a biological mechanism (cs) influences treatment responsiveness.

Eligibility criteria:
inclusion criteria: * 18 years of age or older * diagnosis of ic/bps as given by providers or indicated by assessments exclusion criteria: * comorbid neurological conditions including spinal cord injury or systematic neurologic illnesses, or central nervous system diseases such as brain tumor or stroke * current or history of diagnosis of primary psychotic or major thought disorder within the past five years * hospitalization for psychiatric reasons other than suicidal ideation, homicidal ideation, and/or ptsd (within the past 5 years) * psychiatric or behavioral conditions in which symptoms are unstable or severe (e.g. current delirium, mania, psychosis, suicidal ideation, homicidal ideation, substance abuse dependency) reported within the past six months * non-english speaking * presenting symptoms at time of screening that would interfere with participation, specifically active suicidal ideation with intent to harm oneself or active delusional or psychotic thinking * difficulties or limitations communicating over the telephone * any planned life events that would interfere with participating in the key elements of the study * any major active medical issues that could preclude participation * currently being treated for cancer * cancer-related pain * currently engaged in individual counseling/psychotherapy or unwilling to pause this treatment for the trial duration

Keywords: interstitial cystitis bladder pain syndrome clinical trial psychosocial intervention pelvic pain therapy urological chronic pelvic pain syndrome chronic prostatitis self-management cognitive behavioral therapy