University Medical Center Freiburg, Department of Psychiatry and Psychotherapy, Freiburg, Germany.
J Sex Med. 2012 Dec;9(12):3108-25. doi: 10.1111/j.1743-6109.2012.02965.x. Epub 2012 Oct 22.
As yet, a summary of the research evidence concerning the efficacy of psychological treatment in female sexual dysfunction is lacking. Previous reviews were often nonsystematic or explored one specific sexual dysfunction.
Our systematic review provides an overview of the efficacy of psychosocial interventions in all female sexual dysfunction.
Main outcome measures included for example psychometrically validated scales, diary notes, interviews, and vulvar algesiometer. The efficacy of psychosocial interventions was measured for example by the frequency of and satisfaction with sexual activity and sexual functioning. Safety and acceptance were evaluated on the basis of adverse events and dropout rates.
The systematic literature search included electronic database search, handsearch, contact with experts, and an ancestry approach. Studies were included if the woman was given a formal diagnosis of a sexual dysfunction (International Statistical Classification of Diseases and Related Health Problems-ICD10/-9; Diagnostic and Statistical Manual of Mental Disorders-IV/-III-R) and when the intervention was psychosocial or psychotherapeutic. The control group included either another treatment or a waiting-list control group. The report of relevant outcomes was necessary for inclusion as well as the design of the study (randomized, controlled trials [RCTs] and controlled clinical trials). The assessment of methodological quality comprised aspects of randomization, blinding, incomplete outcome data, selective reporting, and allegiance.
We identified 15 RCTs that investigated efficacy in female sexual dysfunction and two further studies that examined male and female sexual dysfunction together. Most trials explored sexual pain disorders. About half of all studies in women used either a concept derived from Masters and Johnson or a cognitive-behavioral treatment program. Both approaches showed significant improvements compared with a control group. Benefit was not always maintained over the (variable) follow-up period.
Traditional sexual therapeutic concepts proved to be efficacious in the treatment of female sexual dysfunction. A shortcoming was the rather low methodological quality of included studies.
目前，缺乏关于心理治疗对女性性功能障碍疗效的研究证据总结。以前的综述往往是非系统性的，或者只探讨了一种特定的性功能障碍。
我们的系统综述提供了一个概述，即所有女性性功能障碍的心理社会干预的疗效。
主要观察指标包括心理计量学验证量表、日记记录、访谈和外阴痛觉计。心理社会干预的疗效通过性活动和性功能的频率和满意度来衡量。安全性和可接受性基于不良事件和退出率进行评估。
系统文献检索包括电子数据库检索、手工检索、与专家联系和追溯法。如果女性被正式诊断为性功能障碍（国际疾病分类和相关健康问题-ICD10/-9；精神障碍诊断和统计手册-IV/-III-R），并且干预是心理社会或心理治疗，那么研究就会被纳入。对照组包括另一种治疗或等待名单对照组。纳入的必要条件是报告相关结果以及研究设计（随机对照试验[RCT]和对照临床试验）。方法学质量评估包括随机化、盲法、不完整结局数据、选择性报告和一致性等方面。
我们确定了 15 项 RCT 研究，这些研究调查了女性性功能障碍的疗效，还有两项进一步的研究调查了男性和女性性功能障碍一起的疗效。大多数试验都探讨了性疼痛障碍。约一半的女性研究使用了 Masters 和 Johnson 的概念或认知行为治疗方案。与对照组相比，这两种方法都显示出显著的改善。但在（不同的）随访期间，获益并不总是持续。
传统的性治疗概念在治疗女性性功能障碍方面被证明是有效的。一个缺点是纳入研究的方法学质量相对较低。
