Department of Psychology, Wayne State University, Detroit, Michigan.
Women's Urology, Beaumont Health System, Royal Oak, Michigan.
Pain Med. 2019 Jul 1;20(7):1321-1329. doi: 10.1093/pm/pny182.
Women with chronic urogenital pain (CUP) conditions have elevated rates of lifetime trauma, relational stress, and emotional conflicts, but directly assessing and treating psychological stress is rarely done in women's health care settings. We developed and tested the effects on patients' somatic and psychological symptoms of a life stress interview that encourages disclosure about stressors and uses experiential techniques to increase awareness of links between stress, emotions, and symptoms.
In this randomized trial, women with CUP recruited at a multidisciplinary women's urology center received either a single 90-minute life stress interview (N = 37) or no interview (treatment-as-usual control; N = 25). Self-report measures of pain severity (primary outcome), pain interference, pelvic floor symptoms, and psychological symptoms (anxiety and depression) were completed at baseline and six-week follow-up.
Differences between the life stress interview and control conditions at follow-up were tested with analyses of covariance, controlling for baseline level of the outcome and baseline depression. Compared with the control condition, the interview resulted in significantly lower pain severity and pelvic floor symptoms, but the interview had no effect on pain interference or psychological symptoms.
An intensive life stress emotional awareness expression interview improved physical but not psychological symptoms among women with CUP seen in a tertiary care clinic. This study suggests that targeting stress and avoided emotions and linking them to symptoms may be beneficial for this complex group of patients.
患有慢性泌尿生殖系统疼痛（CUP）的女性一生中经历创伤、人际关系紧张和情绪冲突的比率较高，但在女性保健环境中很少直接评估和治疗心理压力。我们开发并测试了一种生活压力访谈的效果，该访谈鼓励患者披露压力源，并使用体验技术来提高对压力、情绪和症状之间联系的认识，以此改善患者的躯体和心理症状。
在这项随机试验中，在多学科女性泌尿科中心招募的患有 CUP 的女性接受了单次 90 分钟的生活压力访谈（N=37）或未接受访谈（常规治疗对照；N=25）。在基线和六周随访时，使用疼痛严重程度（主要结局）、疼痛干扰、盆底症状和心理症状（焦虑和抑郁）的自我报告措施进行评估。
采用协方差分析比较生活压力访谈和对照组在随访时的差异，控制结局的基线水平和基线抑郁。与对照组相比，访谈组的疼痛严重程度和盆底症状明显较低，但访谈对疼痛干扰或心理症状没有影响。
在三级护理诊所中，强化生活压力情感意识表达访谈改善了慢性泌尿生殖系统疼痛女性的躯体症状，但对心理症状没有影响。这项研究表明，针对压力和回避情绪，并将其与症状联系起来，可能对这组复杂的患者有益。
