Unexplained medical symptoms in functional medical illnesses present a challenging diagnostic dilemmafor physicians. These conditions usually involve pain or pressure together with other symptoms whichsuggest a combination of biological and unexplained medical factors. Interstitial cystitis (1C), more recentlylabeled Painful Bladder Syndrome (PBS), is a prime example of this type of disorder. Recently, intenseinterest has focused on the psychological/psychiatric components of these disorders. In particular, our teamhas demonstrated that somatization disorder, when present, may influence the course and management ofthese functional medical syndromes. Patients with somatization disorder disproportionately consumeclinicians' time and medical resources. Thus, understanding the role of somatization disorder in IC/PBS hasthe potential to yield clinical and economic benefits.In the present study, 120 patients with IC/PBS will be assessed for physical and psychologicalsymptoms, medically unexplained symptoms, and somatization disorder, and they will also monitored over12 months for temporal symptom patterns and outcomes. The study will demonstrate the proportion ofpatients with IC/PBS who also have somatization disorder and the degree to which these patients representa significantly distinct IC/PBS subgroup with different illness presentation, progression, and outcome.Previous research by this team from similar studies of Irritable Bowel Syndrome (IBS) has generated highlyuseful information and will serve as a template for this research. The comparability of the findings of thisstudy to previous work on IBS will help guide recommendations for modification of pharmacological andpsychological interventions for this patient population. Recognition and appropriate management ofsomatization disorder in patients with IC/PBS has the potential to benefit a substantial proportion of patientswith IC/PBS and inform future research. This proposed study truly investigates the interface of medicine andpsychiatry in its approach to these disorders.
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