title: The relaxation exercise and social support trial-resst: study protocol for a randomized community based trial.
abstract: BACKGROUND
  Studies suggests a possible link between vaginal discharge and common mental distress, as well as highlight the implications of the subjective burden of disease and its link with mental health.
  
  
  METHODS
  This is a community-based intervention trial that aims to evaluate the impact of a psycho-social intervention on medically unexplained vaginal discharge (MUVD) in a group of married, low-income Lebanese women, aged 18-49, and suffering from low to moderate levels of anxiety and/or depression. The intervention consisted of 12 sessions of structured social support, problem solving techniques, group discussions and trainer-supervised relaxation exercises (twice per week over six weeks). Women were recruited from Hey el Selloum, a southern disadvantaged suburb of Beirut, Lebanon, during an open recruitment campaign. The primary outcome was self-reported MUVD, upon ruling out reproductive tract infections (RTIs), through lab analysis. Anxiety and/or depression symptoms were the secondary outcomes for this trial. These were assessed using an Arabic validated version of the Hopkins Symptoms Checklist-25 (HSCL-25). Assessments were done at baseline and six months using face-to face interviews, pelvic examinations and laboratory tests. Women were randomized into either intervention or control group. Intent to treat analysis will be used.
  
  
  CONCLUSIONS
  The results will indicate whether the proposed psychosocial intervention was effective in reducing MUVD (possibly mediated by common mental distress).
  
  
  BACKGROUND
  The trial is registered at the Wellcome Trust Registry, ISRCTN assigned: ISRCTN: ISRCTN98441241.
authors.affiliation: UCLA, School of Public Health, Community Health Sciences Department, Los Angeles, California 90095, USA. loulou.kobeissi@gmail.com
authors.forename: Loulou
authors.initials: L
authors.lastname: Kobeissi
authors.forename: Ricardo
authors.initials: R
authors.lastname: Araya
authors.forename: Fayssal
authors.initials: F
authors.lastname: El Kak
authors.forename: Zeina
authors.initials: Z
authors.lastname: Ghantous
authors.forename: Marwan
authors.initials: M
authors.lastname: Khawaja
authors.forename: Brigitte
authors.initials: B
authors.lastname: Khoury
authors.forename: Ziyad
authors.initials: Z
authors.lastname: Mahfoud
authors.forename: Rima
authors.initials: R
authors.lastname: Nakkash
authors.forename: Tim J
authors.initials: TJ
authors.lastname: Peters
authors.forename: Sami
authors.initials: S
authors.lastname: Ramia
authors.forename: Huda
authors.initials: H
authors.lastname: Zurayk
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000150:complications / Q000523:psychology / Q000628:therapy*; D002985:Clinical Protocols; D055812:Community-Based Participatory Research / Q000379:methods*; D003863:Depression / Q000150:complications / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011340:Problem Solving; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group / Q000379:methods*; D012064:Relaxation Therapy / Q000379:methods / Q000523:psychology*; D012944:Social Support; D019522:Vaginal Discharge / Q000150:complications / Q000523:psychology* / Q000628:therapy*