The Relaxation Exercise and Social Support Trial (RESST): a community-based randomized controlled trial to alleviate medically unexplained vaginal discharge symptoms

BMC Psychiatry

Research Article

Ricardo Araya¹  Rima Nakkash²  Marwan Khawaja³  Zeina Ghantous³  Huda Zurayk³  Fayssal El Kak⁴  Brigitte Khoury⁵  Ziyad Mahfoud⁶  Loulou Kobeissi⁷  Sami Ramia⁸  Tim J Peters⁹ 

[1] Academic Unit of Psychiatry School of Social and Community Medicine, University of Bristol, Bristol, UK;Center for Research on Population and Health Department of Health Promotion and Community Health Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon;Center for Research on Population and Health Epidemiology and Population Health Department Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon;Department of Health Promotion and Community Health Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon;Department of Psychiatry-Faculty of Medicine, American University of Beirut, Beirut, Lebanon;Department of Public Health, Weill Cornell Medical College, Doha, Qatar;Epidemiology and Biostatistics Division, Center for Middle Eastern Studies, University of Arizona, Tucson, Arizona, USA;Center for Research on Population and Health Epidemiology and Population Health Department Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon;Medical Lab Sciences Program Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon;School of Clinical Sciences, University of Bristol, Bristol, UK;

关键词: Bacterial Vaginosis;    Common Mental Disorder;    Informal Settlement;    Vaginal Discharge;    Important Public Health Problem;   

DOI  :  10.1186/1471-244X-12-195

 received in 2012-04-20, accepted in 2012-10-25,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundSymptoms such as medically unexplained vaginal discharge (MUVD) are common and bothersome, leading to potentially unnecessary use of resources.MethodsA community-based individually randomized controlled trial to assess the effectiveness of a relatively simple, culturally appropriate multi-component intervention on reducing reported MUVD, among women suffering from low-moderate levels of common mental distress. The setting was a socio-economically deprived, informal settlement in the southern suburbs of Beirut, Lebanon. The intervention comprised up to 12 group sessions implemented over a six-week period, each divided into a psychosocial and a relaxation exercise component. The primary outcome was self-reported MUVD, which was defined as a complaint of vaginal discharge 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. Blinding on the intervention status was not possible for both logistic and ethical reasons, especially as knowledge of involvement in the intervention was integral to its delivery. Intent to treat analysis was used.ResultsOf 75 women randomized to the intervention, 48% reported MUVD at 6 months compared with 63% of 73 in the control group (difference of -15%, 95% confidence interval (CI) -31%, 0%, p=0.067). Adjustments for baseline imbalances and any factors relating to consent had no appreciable effect on these results. The risk of MUVD was reduced in absolute terms by 2.4% for each intervention session attended (95% CI -4.9%, 0.0%, p=0.049). While there was also marginal evidence of a beneficial effect on anxiety, there was no evidence of mediation of the effect on MUVD through measures of common mental disorders.ConclusionThis study confirms that MUVD is an important public health problem. While the benefits of this intervention may appear modest, the intervention offers an opportunity for women to enhance their problem-solving skills as well as use physical relaxation techniques that can help them deal with stressful in their lives. Further research is needed in a variety of contexts, for different populations and preferably involving larger randomized trials of such an intervention.Trial registration* Title of trial: The Relaxation Exercise and Social Support TrialISRCTN assigned: ISRCTN98441241Date of assignation: 10/09/2010Link: http://www.controlled-trials.com/ISRCTN98441241* Also registered at the Wellcome Trust register:http://www.controlled-trials.com/mrct/trial/469943/98441241

【 授权许可】

Unknown   
© Kobeissi et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.