Division of Epidemiology & Community Health, School of Public Health, Minneapolis, Minnesota 55454, USA.
J Womens Health (Larchmt). 2011 Oct;20(10):1445-51. doi: 10.1089/jwh.2010.2661. Epub 2011 Aug 8.
Studies have shown that women with vulvodynia are more psychologically distressed than women without vulvodynia. These studies, however, have not effectively established temporal associations between diagnosed psychiatric disorders and vulvodynia.
The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) was administered to 240 case-control pairs of women with and without vulvodynia. Interviews established age at first onset of diagnosed mood and anxiety disorder. Age information was used to determine whether the first episode of mood and/or anxiety was antecedent or subsequent to the first onset of vulvodynia symptoms. Conditional logistic regressions tested whether antecedent depression or anxiety was more likely among women with or without vulvodynia. Cox proportional hazards modeling was then used to estimate risk of subsequent new or recurrent onset of mood or anxiety disorder.
After adjusting for education, race, age at menarche, age at first tampon use, and age at first sexual intercourse, odds of vulvodynia were four-times more likely among women with antecedent mood or anxiety compared to women without (95% confidence interval [CI] 2.1-7.5). Vulvodynia was associated with new or recurrent onset of mood or anxiety disorder after adjustment (hazard ratio [HR] 1.7, 95% CI 1.1-2.6) and did not significantly change after including history of mood or anxiety disorder before the onset of vulvodynia or reference age of controls in the models.
This is the first community-based epidemiologic study demonstrating that DSM-IV-diagnosed antecedent depression and anxiety disorders influence the risk of vulvodynia and that vulvodynia increases the risk of both new and recurrent onset of psychopathology.
研究表明，患有外阴痛的女性比没有外阴痛的女性心理困扰更大。然而，这些研究并没有有效地确定诊断出的精神障碍与外阴痛之间的时间关联。
对 240 对有和没有外阴痛的病例对照妇女进行了 DSM-IV 轴 I 障碍的结构性临床访谈（SCID）。访谈确定了首次诊断为心境和焦虑障碍的年龄。使用年龄信息来确定心境和/或焦虑的首次发作是外阴痛症状的前驱还是后继。条件逻辑回归检验了患有或不患有外阴痛的女性中前驱性抑郁或焦虑是否更常见。然后使用 Cox 比例风险模型来估计随后新发或复发性心境或焦虑障碍的风险。
在校正教育、种族、初潮年龄、首次使用卫生棉条年龄和首次性行为年龄后，前驱性心境或焦虑的女性发生外阴痛的可能性是没有前驱性心境或焦虑的女性的四倍（95%置信区间[CI] 2.1-7.5）。外阴痛与新发或复发性心境或焦虑障碍相关，调整后（危险比[HR] 1.7，95%CI 1.1-2.6），在模型中包括外阴痛发作前的心境或焦虑障碍史或对照组的参考年龄后，并没有显著改变。
这是第一项基于社区的流行病学研究，表明 DSM-IV 诊断的前驱性抑郁和焦虑障碍会影响外阴痛的风险，而外阴痛会增加新发和复发性精神病理学的风险。
