A randomized controlled trial of a cognitive-behavioural group intervention versus waiting-list control for women with uterovaginal agenesis (Mayer-Rokitansky-Küster-Hauser syndrome: MRKH).
BACKGROUND
Uterovaginal agenesis (Mayer-Rokitansky-Küster-Hauser syndrome: MRKH) is a congenital abnormality of the female genital tract, characterized by the non-formation of the vagina and uterus. There is a widespread agreement that MRKH has a lasting negative psychological impact on women with this condition, but as yet little is known about how to conceptualize and manage this. We developed a cognitive-behavioural group treatment (CBT) of MRKH. The aim of the present study was to determine whether this intervention, compared to waiting-list control, improves psychosocial outcomes in women with MRKH.


METHODS
After stratifying for age and type of MRKH (simple or complex), 39 women with MRKH were randomized to group CBT (n = 19) or waiting list (n = 20). Outcomes were assessed at pre-treatment, post-treatment (7 weeks) and at 3 months follow-up. The main outcome measure was the Symptom Check-List (SCL-90-R). Other outcomes included impact of event, self-esteem and interpersonal functioning.


RESULTS
Participants allocated to group CBT showed significantly reduced psychological symptoms on the SCL-90-R and non-significant improvements on all secondary outcomes at the end of treatment and follow-up, whereas those on the waiting list remained unchanged.


CONCLUSIONS
A group CBT intervention improves psychological outcomes in MRKH. This treatment may also be applicable to other gynaecological conditions.
Heller-Boersma
J G
JG
The National Centre for Adolescent and Adult Women with Congenital Abnormalities of the Genital Tract, Queen Charlotte's and Chelsea Hospital, Du Cane Road, London, UK. scalingyourmountains@bigpond.com
Schmidt
U H
UH
Edmonds
D K
DK
D000015:Abnormalities, Multiple / Q000523:psychology; D000293:Adolescent; D000328:Adult; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group; D013577:Syndrome; D016896:Treatment Outcome; D014599:Uterus / Q000002:abnormalities*; D014621:Vagina / Q000002:abnormalities*; D014850:Waiting Lists