title: Clinical characteristics and psychopathological profile of patients with vulvodynia: an observational and descriptive study.
abstract: BACKGROUND
  Vulvodynia is a fairly common dermatological symptom that often interferes with the personal, social and working activities of affected women and results in a significant loss of their quality of life. It is a persistent and tedious clinical disorder which is often resistant to conventional treatments.
  
  
  OBJECTIVE
  The aim of this study is to evaluate the main clinical signs, associated psychopathological disorders and outcome after antidepressant treatment of patients with vulvodynia.
  
  
  METHODS
  Eighty patients were included. Clinical characteristics and psychopathological profiles were determined by appropriate instruments. The improvement of clinical symptoms after combined antidepressant drug therapy was also evaluated.
  
  
  RESULTS
  Pain (70%), burning (63.7%), dyspareunia (57.5%) and stinging (56.2%) were the most commonly reported symptoms. Most patients (56.5%) showed anxiety, and 52.2% of them were reported as having a depression disorder. When evaluated by psychometric tools, 81.4% of patients scored >150 on the Life Event Scale, which means a risk >50% of suffering an illness in the near future, and patients' scores in the Dermatology Life Quality Index showed higher values than the mean of the Spanish validation group. After 6 months of combined treatment with escitalopram (10-20 mg/day), perfenazine (2-4 mg/day) and amytriptiline (10 mg/day), a complete remission of the clinical symptoms was achieved in 41% of patients. In contrast, only 12% of patients who did not follow drug treatment reported a complete resolution of the clinical symptoms.
  
  
  CONCLUSIONS
  Our results seem to confirm that vulvodynia is associated with psychiatric co-morbidity such as stress and depression. The study highlights that the psychiatric treatment may be a useful option to improve clinical symptoms. Whether these patients should be evaluated for depression or be referred to a psychiatrist, remains to be investigated.
authors.affiliation: Department of Dermatology, Hospital del Mar, Universitat Autónoma de Barcelona, Barcelona, Spain. 23849jtb@comb.es
authors.forename: M J
authors.initials: MJ
authors.lastname: Tribó
authors.forename: O
authors.initials: O
authors.lastname: Andión
authors.forename: S
authors.initials: S
authors.lastname: Ros
authors.forename: M
authors.initials: M
authors.lastname: Gilaberte
authors.forename: F
authors.initials: F
authors.lastname: Gallardo
authors.forename: A
authors.initials: A
authors.lastname: Toll
authors.forename: M
authors.initials: M
authors.lastname: Ferrán
authors.forename: A
authors.initials: A
authors.lastname: Bulbena
authors.forename: R M
authors.initials: RM
authors.lastname: Pujol
authors.forename: J E
authors.initials: JE
authors.lastname: Baños
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage*; D001008:Anxiety Disorders / Q000150:complications* / Q000188:drug therapy; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000150:complications* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D017699:Pelvic Pain / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D018709:Statistics, Nonparametric; D014845:Vulvar Diseases / Q000150:complications / Q000188:drug therapy / Q000523:psychology*
chemical_list: D000928:Antidepressive Agents