Clinical characteristics and psychopathological profile of patients with vulvodynia: an observational and descriptive study

Dermatology. 2008;216(1):24-30. doi: 10.1159/000109354.

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.

Objectives: 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.

MeSH terms

  • Adult
  • Aged
  • Antidepressive Agents / administration & dosage*
  • Anxiety Disorders / complications*
  • Anxiety Disorders / drug therapy
  • Case-Control Studies
  • Depressive Disorder / complications*
  • Depressive Disorder / drug therapy
  • Drug Therapy, Combination
  • Female
  • Humans
  • Middle Aged
  • Pain Measurement
  • Pelvic Pain / complications
  • Pelvic Pain / drug therapy
  • Pelvic Pain / psychology*
  • Psychiatric Status Rating Scales
  • Quality of Life
  • Statistics, Nonparametric
  • Vulvar Diseases / complications
  • Vulvar Diseases / drug therapy
  • Vulvar Diseases / psychology*

Substances

  • Antidepressive Agents