title: A randomized clinical trial for women with vulvodynia: Cognitive-behavioral therapy vs. supportive psychotherapy.
abstract: Many treatments used for women with vulvodynia are based solely upon expert opinion. This randomized trial aimed to test the relative efficacy of cognitive-behavioral therapy (CBT) and supportive psychotherapy (SPT) in women with vulvodynia. Of the 50 participants, 42 (84%) completed 10-week treatments and 47 (94%) completed one-year follow-up assessments. Mixed effects modeling was used to make use of all available data. Participants had statistically significant decreases in pain severity (p's<0.001) with 42% of the overall sample achieving clinical improvement. CBT, relative to SPT, resulted in significantly greater improvement in pain severity during physician examination (p=0.014), and greater improvement in sexual function (p=0.034), from pre- to post-treatment. Treatment effects were well maintained at one-year follow-up in both groups. Participants in the CBT condition reported significantly greater treatment improvement, satisfaction and credibility than participants in the SPT condition (p's<0.05). Findings from the present study suggest that psychosocial treatments for vulvodynia are effective. CBT, a directed treatment approach that involves learning and practice of specific pain-relevant coping and self-management skills, yielded better outcomes and greater patient satisfaction than a less directive approach.
authors.affiliation: Yale University School of Medicine, P.O. Box 208098, New Haven, CT 06520-8098, USA. robin.masheb@yale.edu
authors.forename: Robin M
authors.initials: RM
authors.lastname: Masheb
authors.forename: Robert D
authors.initials: RD
authors.lastname: Kerns
authors.forename: Christine
authors.initials: C
authors.lastname: Lozano
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Minkin
authors.forename: Susan
authors.initials: S
authors.lastname: Richman
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004311:Double-Blind Method; D004644:Emotions / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005608:Free Association; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D017699:Pelvic Pain / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D012189:Retrospective Studies; D012725:Sexual Behavior; D016896:Treatment Outcome; D014623:Vaginal Diseases / Q000150:complications / Q000628:therapy; D055815:Young Adult