Psychodermatology: a study on Vulvodynia
Vulvodynia is a symptom that interferes with life of affected women, resulting in a loss of their quality of life, often resistant to conventional treatments. The aim of this study is to evaluate clinical signs, associated psychopathological disorders and outcome after antidepressant treatment.
In the Unit of Psychodermatology (Hospital del Mar, Barcelona) a study with eighty patients diagnosed of vulvodynia was done. Clinical characteristics, psychopathological profiles and improvement of symptoms after antidepressant therapy were evaluated.
Pain (70%), burning (63.7%), dyspareunia (57.5%) and stinging (56.2%) were the most reported symptoms. 56.5% of patients showed anxiety, 52.2% of them reported a depression disorder. 81.4% of patients scored more than 150 in Life Event Scale, which means a risk above 50% of suffering an illness in the future, and patients’ scores in Dermatology Life Quality Index (DQLI) were higher than the mean of the Spanish validation group. After 6 months of treatment with escitalopram (10-20mg/daily), perfenazine (2-4mg/daily), amytriptiline (10mg/daily), 41% of patients achieved complete remission. 12% patients without drug treatment reported complete resolution.
In conclusion, our results confirm that vulvodynia is associated with psychiatric co-morbidity. The study highlights the psychiatric treatment may be useful. Whether these patients should be evaluated for depression or be referred to a psychiatrist remains to be investigated.
Universitat Autònoma de Barcelona
Department de Dermatologia, Hospital del Mar,
References
"Clinical characteristics and psychopathological profile of patients with vulvodynia: An observational and descriptive study" Tribó MJ, Andión O, Ros S, Gilaberte M, Gallardo F, Toll A, Ferrán M, Bulbena A, Pujol RM, Baños JE. Dermatology. 2008;216(1):24-30.
