Stress and symptoms in patients with interstitial cystitis: A life stress model

Objectives. Stress-related exacerbation of interstitial cystitis (IC) sympt oms has frequently been reported. Previous research has found stress-relate d IC symptom exacerbation in an experimental model. However, this relations hip has not been objectively examined with daily life stressors. We used a prospective daily symptom diary method to investigate the relationships amo ng stress and bladder symptoms in patients with IC and age-matched healthy controls. Methods, Forty-five previously diagnosed female patients with IC completed a bladder symptom and stress diary nightly for 1 month; 31 female age-match ed healthy controls completed a similar diary for 7 days. The symptom quest ions were modified from the Interstitial Cystitis Data Base study. Results. Patients reported greater mean daily stress, bladder pain, urgency , and daytime and nocturnal frequency than controls (all P values less than 0.001). Among all patients, a significant relationship between stress and urgency was observed. In addition, a significant relationship between stres s and pain was observed among patients with moderate and severe disease. As the disease severity increased, more pronounced relationships between stre ss and the symptoms of urgency and pain were evidenced. Greater stress was associated with greater nocturnal frequency among patients with more severe disease. These stress-symptom relationships were not observed among the co ntrols. Conclusions. Higher levels of stress were related to greater pain and urgen cy in patients with IC but not in the controls. In addition, the relationsh ip of stress and these IC symptoms was stronger among patients with more se vere disease. The results indicate that life stress is associated with grea ter IC symptoms, particularly among patients whose disease is not well cont rolled. UROLOGY 57: 422-427, 2001. (C) 2001, Elsevier Science Inc.