Untreated Minds, Unresolved Pain: Treatment Disparities in Patients with Interstitial Cystitis and Depression

Abstract

Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is frequently associated with depression, yet the concurrent management of these conditions remains insufficiently characterized. Co-occurring depression and IC/BPS have been associated with increased symptom burden and reduced quality of life. This study evaluated the prevalence and pharmacologic management of depression among commercially insured patients with IC/BPS. A
retrospective chart review of approximately 600 patient records from a private urogyn ecology practice identified approximately 200 patients with an ICD-10 diagnosis of IC/BPS. Demographic characteristics, treatment status, and comorbidity data were extracted. Eligible patients reported depression before IC/BPS diagnosis and had completed an intake questionnaire. Associations among depression, IC/BPS status, treatment patterns, and chronic comorbidities were evaluated using chi-square analyses. Depression was reported in 35.70% of patients with IC/BPS and 28.86% of patients without IC/BPS; however, this difference did not reach statistical significance (p = 0.0941). Among patients with self-reported depression, 26.77% were not receiving antidepressant therapy. Patients with concurrent IC/BPS and depression were significantly less likely to receive treatment for both conditions than patients with a single condition (70.92% vs. 90.06%, p < 0.0001). Patients with chronic comorbid conditions demonstrated significantly higher rates of IC/BPS than those without chronic comorbidities (p < 0.0001). These findings suggest persistent gaps in the integrated management of IC/ BPS and depression. Despite access to commercial insurance, patients with concurrent IC/BPS and depression experienced lower rates of treatment for both conditions, highlighting the need for improved screening strategies and multidisciplinary care models to optimize patient outcomes.