This area deserves further research, especially sexual abuse related to pelvic pain. Many women with CPP are more often sensitized to and focus on a broader range of somatic input compared to other medical patients. However, it remains unclear which started first-pain or somatization. Common psychological problems Women with CPP are more likely to develop secondary depression, anxiety disorders, substance abuse, or sexual dysfunction due to the frustrating process of seeking help and the progression of their pain. Depression in such patients is common and tends to be a form of learned helplessness.
Patients report symptoms of dysphoria, anhedonia, pessimism, inertia, irritability, and despair.
A small but significant number describe increasing suicidal ideation when nothing can be done to alleviate their pain or to help them return to a modicum of daily functioning. The anxiety and fear described by CPP patients takes on a ruminative, almost obsessive-compulsive style. They tend to catastrophize and develop superstitions about pain and certain behaviors. This sometimes exacerbates pain related to disuse, which can stem from fear of pain. More often, however, fear of the consequences of disuse causes CPP patients to overcompensate with excessive activities, especially when feeling better.