Psychotherapy and Psychotherapeutic Techniques for the Treatment of Vulvodynia: A Systematic Review and Meta-Analysis.

IF 2.4 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Lower Genital Tract Disease Pub Date : 2025-02-24 DOI:10.1097/LGT.0000000000000881

Janice F Queiroz, Ayane C A Sarmento, Antonio C Q Aquino, Amaxsell Thiago Barros de Souza, Kleyton Santos de Medeiros, Megan L Falsetta, Ana Katherine Gonçalves

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引用次数: 0

Abstract

Objectives: To assess the effectiveness of psychotherapy and psychotherapeutic techniques for reduction of vulvar pain and the improvement of sexual function and psychological adjustment in vulvodynia.

Material and methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. PubMed, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, PsycInfo, and Clinical Trial Databases were searched on July 19, 2024. We included randomized controlled trials comparing psychotherapy interventions and psychotherapeutic techniques for vulvodynia. The risk of bias was assessed using the Cochrane Risk of Bias (RoB 2.0) tool. RevMan 5.4 was used for data synthesis. The Grading of Recommendations Assessment Development (GRADE) and Evaluation method was used to assess the strength of the evidence.

Results: A total of 1,884 articles were retrieved. Eight studies met the eligibility criteria and were included in the systematic review, comprising 689 participants. Two studies were included in the meta-analysis, these with 143 participants. When comparing the Acceptance and Commitment Therapy (ACT) with the control group, the mean difference (MD) in the pooled analysis for the Chronic Pain Acceptance Questionnaire did not differ significantly between ACT therapy and other therapies for posttreatment assessment (MD = 0.77; 95% CI = 3.45-4.99). Only 1 study was at high risk of bias due to a lack of clarity about the outcome measurement process. The GRADE rating for the certainty of the evidence for vulvar pain acceptance using ACT was considered low.

Conclusions: Psychotherapy significantly improves vulvar pain, psychological adjustment, and sexual function in women with vulvodynia. Additionally, our meta-analysis showed that ACT and other psychotherapeutic interventions improve psychological adjustment through pain acceptance. However, more rigorous studies are needed to improve the quality of evidence and inform clinical practice.

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来源期刊

Journal of Lower Genital Tract Disease OBSTETRICS & GYNECOLOGY-

CiteScore

6.80

自引率

8.10%

发文量

158

审稿时长

6-12 weeks

期刊介绍： The Journal of Lower Genital Tract Disease is the source for the latest science about benign and malignant conditions of the cervix, vagina, vulva, and anus. The Journal publishes peer-reviewed original research original research that addresses prevalence, causes, mechanisms, diagnosis, course, treatment, and prevention of lower genital tract disease. We publish clinical guidelines, position papers, cost-effectiveness analyses, narrative reviews, and systematic reviews, including meta-analyses. We also publish papers about research and reporting methods, opinions about controversial medical issues. Of particular note, we encourage material in any of the above mentioned categories that is related to improving patient care, avoiding medical errors, and comparative effectiveness research. We encourage publication of evidence-based guidelines, diagnostic and therapeutic algorithms, and decision aids. Original research and reviews may be sub-classified according to topic: cervix and HPV, vulva and vagina, perianal and anal, basic science, and education and learning. The scope and readership of the journal extend to several disciplines: gynecology, internal medicine, family practice, dermatology, physical therapy, pathology, sociology, psychology, anthropology, sex therapy, and pharmacology. The Journal of Lower Genital Tract Disease highlights needs for future research, and enhances health care. The Journal of Lower Genital Tract Disease is the official journal of the American Society for Colposcopy and Cervical Pathology, the International Society for the Study of Vulvovaginal Disease, and the International Federation of Cervical Pathology and Colposcopy, and sponsored by the Australian Society for Colposcopy and Cervical Pathology and the Society of Canadian Colposcopists.