Dissociation Among Women with Chronic Pelvic Pain: Relation to Surgical Treatment, Pelvic Pain Severity, and Health-Related Quality of Life

ABSTRACT

Chronic pelvic pain (CPP) is associated with a history of trauma and symptoms of somatoform dissociation. We aimed to describe how somatoform dissociation impacts CPP symptoms, surgical treatment, and health-related quality of life (HRQOL). Patients (N = 133) diagnosed with CPP presenting for an appointment at a women’s health clinic between November, 2019 – July, 2021 were recruited to participate in a cross-sectional study and complete a survey assessing symptoms of somatoform dissociation, post-traumatic stress disorder (PTSD), pelvic pain severity, history of CPP-related surgeries, and mental and physical HRQOL. We also conducted a post-hoc analysis assessing correlations of individual symptom items on the Somatoform Dissociation Questionnaire (SDQ-20) with HRQOL outcomes. We did not find a relationship between somatoform dissociation and pelvic pain severity or surgical history. Physical HRQOL outcomes were related to somatoform dissociation, PTSD symptoms, and pelvic pain severity, while mental HRQOL outcomes were connected to somatoform dissociation and PTSD symptoms. Our study reveals preliminary evidence suggesting that among CPP patients, HRQOL outcomes are affected by unique profiles of positive and negative symptoms of somatoform dissociation, including sensory disturbances, localized genital pain, and generalized numbness and bodily analgesia. Addressing specific symptoms of somatoform dissociation may enhance HRQOL among trauma-exposed women with CPP. Replication studies are needed to validate our findings. Integrating trauma-informed approaches, including standardized evaluations of trauma exposure and symptoms of somatoform dissociation into routine care for women with CPP is encouraged.

KEYWORDS:

• Chronic pelvic pain
• somatoform dissociation
• post-traumatic stress
• pain severity
• health-related quality of life

Author note

Portions of these findings were presented at the 48^th Annual Scientific Meeting of the Society for Gynecological Surgeons in San Antonio, TX (March, 2022).

Acknowledgments

This study was generously funded, in part, by the David Caul Graduate Research Grant, awarded by the International Society for the Study of Trauma and Dissociation. The funders had no role in the study design, collection, analyses, or interpretation of the data, nor in the writing of or decision to submit this article for publication.

Disclosure statement

This study was generously funded, in part, by the David Caul Graduate Research Award from the International Society for the Study of Trauma and Dissociation (L.S.P). The funders had no role in the study design, collection, analyses, or interpretation of the data, nor in the writing of or decision to submit this article for publication. R.G.R. reports receiving royalties from UpToDate, and travel and stipend funds from the International Urogynecology Association. M.T.B. is aproctor at Intuitive Surgical. C.A.S., S.N, and S.D.report no conflict of interest.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author, Lisa S. Panisch, upon reasonable request.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/15299732.2023.2168828

Additional information

Funding

This work was supported by the International Society for the Study of Trauma and Dissociation [David Caul Graduate Research Award].