Psychological profiles among women with vulvar vestibulitis syndrome: a chart review

Abstract

The purpose of this study was to assess the prevalence and type of psychological distress in women with vulvar vestibulitis syndrome (VVS). A retrospective chart review was conducted of all women receiving a diagnosis of VVS referred to a tertiary care facility during a two-year period. Brief psychological questionnaires, including the Personality Assessment Screener, Fear of Negative Evaluation Scale, Golombok-Rust Inventory of Sexual Satisfaction, and the Phobia Rating Scale were administered. Fifty-consecutive cases were reviewed along with 12-15 month follow-up data for 41 cases. Phobic anxiety to vaginal touch or entry was significantly higher in women with VVS than normative data. Fear of Negative Evaluation was a strong associated feature, and for 30% approached clinically significant levels. Twenty-six percent showed a moderate, while another 26% showed a mild clinically distressed profile. Negative affect and social withdrawal were among the most frequently endorsed variables. Improvement in allodynia and intercourse were both related to these psychological variables, and a multiple regression analysis supported the use of psychological instruments in addition to standard medical assessment. A subgroup of women with VVS display clinically significant broad based psychological distress that warrants additional assessment. The use of psychological questionnaires in addition to medical assessment of women with VVS may provide valuable information predictive of treatment needs and response.

Assessment of vulvodynia symptoms in a sample of US women: a prevalence survey with a nested case control study

“…Although cases in our survey had a significantly increased odds of reporting several co-morbid chronic medical conditions, depression was the only disorder that remained strongly associated with vulvar pain in both univariate and multiple regression analysis, a finding consistent with previously reported data; [22][23][24][25][26][27][28] however, the direction of association is uncertain, and longitudinal studies are needed to better understand this relationship. Associations found between menstrual complaints and chronic vulvar pain also warrant further consideration.…”

Psychological difficulties within a group of patients with vulvodynia

“…Firstly, as with other dysfunctions, given the lack of clear evidence of psychological aetiology in all patients, the need for adequate physical and psychological multidisciplinary assessment, including asking about specific pain location and circumstances, is vital. Where marked or clinically significant psychological distress is established, this will inform the clinician of treatment needs and likely response to interventions 40 .…”

“…We present some examples of dualistic conceptualization of vulval pain disorders.. Dermatologists often consider there to be two distinct subgroups, an older nulliparous group comprised of women aged between 40 and 65 and constituting the Essential Vulvodynia subgroup primarily, and a younger parous group affecting women aged between 18 and 40 years who suffer from vulvovestibulitis 8 (VVS). However our own survey revealed that a moderate level of women under 40 were diagnosed with essential vulvodynia and a higher number of the women over 40 years were diagnosed with vulvovestibulitis 4 .…”

Vulvodynia: A Psychophysiological Profile Based on Electromyographic Assessment

“…There is a high prevalence of depression and anxiety among vulvodynia patients Masheb et al 2005), likewise physiological research has shown unique characteristics which include, increased density of superficial nerve endings, increased immunoreactivity and nociceptor sensitivity (Bohm-Stark et al 1998, 2001Bohm-Stark et al 1999;Foster et al 2004). Such physiological peculiarities, when considered in conjunction with commonly reported psychological traits of elevated anxiety and depression (Brotto et al 2003;Granot et al 2002;Masheb et al 2005), may potentially constitute a partial predisposition to chronic vulvar pain and possibly moderate the severity of symptoms. It would, therefore, seem appropriate to study this pain syndrome from a psychophysiological perspective (Hubbard 1996;Keefe et al 2004;Severeijns et al 2005;Sullivan et al 2005;Sullivan et al 2001;Turner and Aaron 2001).…”