Laden, Bethany F, Bresee, Catherine, De Hoedt, Amanda et al. · Urology · 2021 · DOI
This study looked at how often people with bladder pain syndrome (IC/BPS) also have other health conditions, using data from a large group of veterans. Researchers found that people with IC/BPS are much more likely to have multiple overlapping conditions—including chronic fatigue syndrome, fibromyalgia, IBS, and migraines—as well as mental health challenges like depression and trauma. These patterns were especially strong in women.
ME/CFS frequently co-occurs with other pain and autonomic conditions, and this study provides epidemiological evidence that IC/BPS shares a similar comorbidity signature—particularly with chronic fatigue syndrome and fibromyalgia. Understanding these overlapping conditions helps validate the biological clustering of neuroimmune disorders and may inform research into shared pathogenic mechanisms.
This study does not establish whether IC/BPS causes these comorbidities, whether a common underlying mechanism drives them, or whether the associations reflect true biological overlap versus diagnostic artifact from ICD coding practices. The cross-sectional design cannot determine temporal relationships or causality. Findings in a veteran population may not generalize to non-veteran populations.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Laden, Bethany F, Bresee, Catherine, De Hoedt, Amanda, Dallas, Kai B, Scharfenberg, April, Saxena, Roopali, et al. (2021). Comorbidities in a Nationwide, Heterogenous Population of Veterans with Interstitial Cystitis/Bladder Pain Syndrome.. Urology. https://doi.org/10.1016/j.urology.2021.04.015
BibTeX
@article{mecfsatlas-laden-2021-comorbidities-nationwide,
author = {Laden, Bethany F and Bresee, Catherine and De Hoedt, Amanda and Dallas, Kai B and Scharfenberg, April and Saxena, Roopali and Senechal, Justin F and Barbour, Kamil E and Kim, Jayoung and Freedland, Stephen J and Anger, Jennifer T},
title = {Comorbidities in a Nationwide, Heterogenous Population of Veterans with Interstitial Cystitis/Bladder Pain Syndrome.},
journal = {Urology},
year = {2021},
doi = {10.1016/j.urology.2021.04.015},
note = {PubMed: 33901534},
url = {https://www.mecfsatlas.com/evidence/laden-2021-comorbidities-nationwide},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/laden-2021-comorbidities-nationwide
Contribute
Private, reviewed by a human. Not a public comment thread.