Chronic pelvic pain as a somatoform disorder

Background: The purpose of th is study was to determine whether psychiatric disturbances, particularly somatization, and an increased number of trauma tic and critical life events, which have been found in women with idiopathi c chronic pelvic pain (ICPP), can also be observed in women with chronic pe lvic pain and abdominal adhesions (ACPP). Methods: Forty women who underwen t diagnostic laparoscopy were subdivided into three groups according to bli nd rated somatic pathologies: ICPP patients (n = 16), ACPP patients (n = 10 ), infertile controls without pain (n = 14). Besides the standardized asses sment of DSM-III-R diagnosis, questionnaires and semistandardized interview s were used to estimate depression, somatization, pain, the prevalence of s exual and physical abuse, and the number of critical life events. Results: Diagnostic criteria for somatoform pain disorder were fullfilled in 73.3% o f the ICPP patients, 60% of the ACPP patients and none of the controls. Wit h respect to the somatization symptom checklist the two pain groups scored significantly higher than the controls (p < 0.05). Referring to perceived p ain, ACPP patients differed from the ICPP patients by one out of seven subs cales (higher persistence of pain; p < 0.05). No correlation was found betw een the intensity of pain and the severity of classified adhesions. The two groups of pain patients significantly differed from controls by a higher p revalence of sexual abuse (p < 0.05). Depression was found neither in the p ain groups nor in the controls. Conclusions: Because high somatization and high prevalence rates of abuse were not only found in patients suffering fr om ICPP but also in ACPP patients, it seems to be doubtful that the somatic pathology may fully explain the psychopathology in patients with ACPP.