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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although there is increasing awareness of the short-term psychological and social adaptations to childhood sexual abuse, little is known about the long-term effects of such abuse, particularly its effect on subsequent medical utilization and the experience and reporting of physical symptoms. We re-analyzed data from a previous study of 100 women scheduled for diagnostic laparoscopy (50 for chronic pain, 50 for tubal ligation or infertility evaluation) who received structured, physician-administered psychiatric and sexual abuse interviews. Women were regrouped by severity of childhood sexual abuse, and we compared the groups with respect to lifetime psychiatric diagnoses and medically unexplained symptom patterns. Unadjusted odds ratios showed that risk for lifetime diagnoses of major depression, panic disorder, phobia, somatization disorder and drug abuse, and current diagnoses of major depression and somatoform pain disorder were significantly higher in the severely abused group compared with women with no abuse or less severe abuse. Logistic regression analysis demonstrated that number of somatization symptoms, lifetime panic disorder and drug dependence were predictive of a prior history of severe childhood sexual abuse. Psychiatric disorders and medical symptoms, particularly chronic pelvic pain, are common in women with histories of severe childhood sexual abuse. Clinicians should inquire about childhood sexual and physical abuse experiences in patients with multiple medical and psychiatric symptoms, particularly patients with chronic pelvic pain.
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PMID:Medical and psychiatric symptoms in women with childhood sexual abuse. 145 59

Two hundred and eleven women between the ages of 18 and 65 years referred to a gynaecological out-patient clinic were screened for psychiatric disorder using the General Health Questionnaire (GHQ) and a Demographic Questionnaire. A random sub-sample of 35 women were interviewed using the Present State Examination (PSE) and the Brown and Harris Life Events and Difficulties Schedule (LEDS), and compared to a general population sample (N = 140) matched for life stage (LS) and social class. Forty six per cent of women in the clinic scored as cases on the GHQ. High scores were associated with being divorced, separated, or widowed, and with complaints of pelvic pain. PSE case rates were higher in the clinic sample than in the general population group (29 per cent and 17 per cent). Younger women (LS 1) and middle class women in the clinic sample had higher rates than in the general population. Only the middle class women in the clinic sample showed significantly higher rates for severely threatening life events and/or difficulties before onset of psychiatric disorder. The study supports the view that rates of psychiatric disorder are high among women referred to a gynaecology clinic and indicates the importance of associations with demographic factors and recent experience of life stress, especially marital difficulties.
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PMID:Psychiatric morbidity in a gynaecology clinic an epidemiological survey. 669 74

The authors evaluated 100 women scheduled for diagnostic laparoscopy (50 for chronic pain, 50 for tubal ligation or infertility evaluation) using structured psychiatric, family history, and sexual trauma interviews. Laparoscopy reports were blindly rated by a gynecologist. Compared with the nonpain group, the women with chronic pelvic pain had significantly higher current and lifetime rates of psychiatric disorders, as well as childhood and adult sexual victimization. They reported significantly higher mean numbers of somatization symptoms, but no significant differences in objective laparoscopic findings. Psychiatric disorders and sexual victimization are common in women with chronic pelvic pain and should be considered in the evaluation and treatment of these patients.
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PMID:Psychiatric diagnoses and sexual victimization in women with chronic pelvic pain. 899 21

Sixty-two gynaecology in-patients were screened for psychiatric disorder and illness behaviour on the eve of elective laparoscopy. Patients with chronic pelvic pain (CPP) reported significantly more depressed mood and illness behaviour than those without pain. Chronic pelvic pain patients with relevant structural pathology at laparoscopy were compared to those with negative laparoscopic findings. The two groups did not differ on measures of psychiatric morbidity or illness behaviour. They differed significantly in response to the McGill Pain Questionnaire. These findings were used to propose a self-report instrument for predicting negative laparoscopic findings in depressed CPP patients pre-operatively.
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PMID:Psychiatric morbidity and illness behaviour in women with chronic pelvic pain. 812 87

The incidence of depressed mood is high in women before hysterectomy. This finding is usually the effect of prolonged heavy periods, chronic pelvic pain, and severe premenstrual syndrome that warrant the surgical treatment. The therapeutic effects of hysterectomy thus include both the cure of physical symptoms and improvement of mood. However, in women with preexisting psychiatric illness or predisposing personality problems, depressed mood may persist or occur with the stress of hysterectomy. Hysterectomy is commonly performed in the perimenopausal age but also results in a premature ovarian failure. Thus, ovarian hormone deficiency following hysterectomy may be responsible for the negative effect on mood. The cyclical nature of such hormone-related depressed states often remains unrecognized in the absence of menstruation; without routine endocrinologic monitoring the need for estrogen replacement following hysterectomy is often missed. Associated bilateral oophorectomy results in the depletion of endogenous androgens, which also has a significant effect on mood. Estrogen plus testosterone replacement following hysterectomy with or without bilateral oophorectomy has been shown to reduce the incidence of depressed state. The compliance with hormone replacement following hysterectomy is high in the absence of withdrawal bleeding and the depressant effect of progestins on mood. Therefore, a practice of regular endocrinologic monitoring following hysterectomy to detect the need for estrogen replacement and a near-routine replacement of combined estrogen and testosterone following bilateral oophorectomy should be adopted to reduce the incidence of posthysterectomy depression.
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PMID:Hysterectomy, ovarian failure, and depression. 1037 28

Chronic prostatitis/chronic pelvic pain syndrome is a common disorder seen in men under the age of 50 and has a considerable negative impact on quality of life; it is a complex and difficult condition to treat, owing to its wide symptomatology. In order to effectively treat this condition, the UPOINT system was developed: it allows clinical profiling of a patient's symptoms into six broad categories (urinary symptoms, psychological dysfunction, organ-specific symptoms, infectious causes, neurologic dysfunction, and tenderness of the pelvic floor muscles) to allow individualized and multimodal therapy. In this review, we present the most recent advancements in the treatment of chronic prostatitis/chronic pelvic pain syndrome from the past few years.
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PMID:Recent advances in managing chronic prostatitis/chronic pelvic pain syndrome. 2903 74

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, defines eating disorders as a "persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning." The correct diagnosis of and distinction between eating disorders are important because the course, prognosis, and treatment may be vastly different. Although the age at peak incidence can vary depending on the eating disorder, these disorders commonly arise during adolescence. Adult and adolescent females with eating disorders may present with gynecologic concerns or symptoms, including irregular menses, amenorrhea, pelvic pain, atrophic vaginitis, and breast atrophy. Although formal diagnosis and treatment of eating disorders in adolescents are complex and outside the scope of practice for most general obstetrician-gynecologists, it is important that health care providers be comfortable with recognizing and screening at-risk patients. Recognizing risk factors for eating disorders can help to identify patients who should be further evaluated. Simply asking the patient how she feels about her weight, what she is eating, how much she is eating, and how much she is exercising can help identify at-risk patients. A physical examination and laboratory tests are valuable in the diagnosis of an eating disorder. Because eating disorders are complex and affect psychologic and physical health, a multidisciplinary approach is imperative. Although obstetrician-gynecologists are not expected to treat eating disorders, they should be familiar with the criteria that warrant immediate hospitalization for medical stabilization.
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PMID:ACOG Committee Opinion No. 740 Summary: Gynecologic Care for Adolescents and Young Women With Eating Disorders. 2979 75

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, defines eating disorders as a "persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning." The correct diagnosis of and distinction between eating disorders are important because the course, prognosis, and treatment may be vastly different. Although the age at peak incidence can vary depending on the eating disorder, these disorders commonly arise during adolescence. Adult and adolescent females with eating disorders may present with gynecologic concerns or symptoms, including irregular menses, amenorrhea, pelvic pain, atrophic vaginitis, and breast atrophy. Although formal diagnosis and treatment of eating disorders in adolescents are complex and outside the scope of practice for most general obstetrician-gynecologists, it is important that health care providers be comfortable with recognizing and screening at-risk patients. Recognizing risk factors for eating disorders can help to identify patients who should be further evaluated. Simply asking the patient how she feels about her weight, what she is eating, how much she is eating, and how much she is exercising can help identify at-risk patients. A physical examination and laboratory tests are valuable in the diagnosis of an eating disorder. Because eating disorders are complex and affect psychologic and physical health, a multidisciplinary approach is imperative. Although obstetrician-gynecologists are not expected to treat eating disorders, they should be familiar with the criteria that warrant immediate hospitalization for medical stabilization.
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PMID:ACOG Committee Opinion No. 740: Gynecologic Care for Adolescents and Young Women With Eating Disorders. 3024 47