Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Greimel, ER; Gartner, MA; Deutsch, MT.
Chronic Pelvic Pain Without Clinical-Evidence - A Symptom for Somatoform Disorders
GEBURTSH FRAUENHEILK 1999 59: 458-464.
Doi: 10.1055/s-1999-5970
Web of Science
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- Führende Autor*innen der Med Uni Graz
- Greimel Elfriede Renate
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- Abstract:
- Objective: Pelvic pain is a frequent problem in gynecologic practice. We studied underlying psychologic factors in patients with chronic pelvic pain. Methods: We analyzed underlying psychosocial factors in 103 patients with chronic pelvic pain. After medical evaluation all patients were interviewed by a clinical psychologist with a series of questions concerning current psychologic symptoms, partnership and family, sexuality, and significant life events. The data were used to categorize the patients according to the ICD-10 criteria of somatoform disorders. Results: 84 patients (82 %) met the ICD-10 criteria for a somatoform disorder. Psychologic evaluation revealed more than one psychophysiologic symptom (e.g., gastrointestinal complaints, sleeping disorders, headache) and various distressing factors in different areas in addition to pelvic pain. More than half of the patients reported problems with partnership and sexuality, 38 % had family problems, and 41 % had psychologic distress in several areas. About one third of the patients reported abusive behavior including sexual abuse within the family, 20 % had traumatic childhood experiences such as personal losses, and 19 % came from broken homes. Although psychologic intervention was indicated and recommended for almost all patients, only 28 % of patients participated while 72 % declined. Conclusions: One of the greatest obstacles to psychologic treatment is the patient's belief that the pain is physical as opposed to psychologic in origin. Chronic pelvic pain is a complex syndrome requiring physical as well as psychologic evaluation. The presence of psychologists at gynecology units is useful to establish a multi-disciplinary treatment plan.