Association of Interstitial Cystitis/Bladder Pain Syndrome with Stress-Related Diseases: A Nationwide Population-Based Study

Min-Hsin Yang; Jing-Yang Huang; Sung-Lang Chen; James Cheng-Chung Wei

doi:10.3390/jcm10235669

Association of Interstitial Cystitis/Bladder Pain Syndrome with Stress-Related Diseases: A Nationwide Population-Based Study

J Clin Med. 2021 Nov 30;10(23):5669. doi: 10.3390/jcm10235669.

Authors

Min-Hsin Yang^{1

2}, Jing-Yang Huang^{1

3}, Sung-Lang Chen^{2

4}, James Cheng-Chung Wei^{4

5

6}

Affiliations

¹ Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan.
² Department of Urology, Chung Shan Medical University Hospital, Taichung 402, Taiwan.
³ Center for Health Data Science, Chung Shan Medical University Hospital, Taichung 402, Taiwan.
⁴ School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan.
⁵ Graduate Institute of Integrated Medicine, China Medical University, Taichung 402, Taiwan.
⁶ Department of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung 402, Taiwan.

Abstract

Background: Stress-related diseases (SRDs) are adjustment disorders triggered by stressful life changes. There is a growing body of evidence showing that stress plays an important role in the pathophysiology of IC/BPS. In the present study, we investigated the association between SRDs and a subsequent association of interstitial cystitis/bladder pain syndrome (IC/BPS).

Methods: We performed a nested case-control study from the Longitudinal Health Insurance Database (LHID) of Taiwan. The two-year time-varying association between SRDs and IC/BPS was explored to distinguish the short- or long-term effects of these factors. We then conducted multiple conditional logistic regressions to evaluate the adjusted odds ratio (OR) of IC/BPS in patients with a history of SRDs.

Results: A total of 1103 IC/BPS patients and 4412 non-IC/BPS patients were analyzed. For all SRDs, the significantly increased risks were obtained in 2 years before IC/BPS diagnosis, and the higher OR was observed within 3 months before the diagnosis of IC/BPS. Multiple conditional logistic regressions showed that patients who had prior medical care for urinary tract infection (OR = 10.95, 95% CI = 9.07 to 13.22), chronic obstructive pulmonary disease (OR = 1.48, 95% CI = 1.13 to 1.93), peptic ulcer (OR = 1.69, 95% CI = 1.37 to 2.09), inflammatory bowel syndrome (OR = 1.66, 95% CI = 1.21 to 2.29), autoimmune diseases (OR = 1.48, 95% CI = 1.11 to 1.97), depression (OR = 1.54, 95% CI = 1.24 to 1.91), sleep disorders (OR = 1.45, 95% CI = 1.19 to 1.78), and allergic rhinitis (OR = 1.29, 95% CI = 1.03 to 1.62) within 2 years had a significant risk of IC/BPS.

Conclusions: Our study demonstrates that the health care for SRDs within the previous 2 years is associated with an increased risk of subsequent IC/BPS. The time-varying association provides an important insight that helps us to identify cases with IC/BPS, especially among patients with repeated UTI visits.

Keywords: interstitial cystitis/bladder pain syndrome; national-based study; stress; stress-related disease.