Psychological therapies for chronic pelvic pain: systematic review of randomized controlled trials.

Background. Chronic Pelvic Pain (CPP), a common cause of disability in women, is a condition best viewed in the biopsychosocial framework. Psychological interventions are frequently considered alongside medical and surgical treatments. Objectives. To evaluate the effectiveness of psychological therapies for the treatment of CPP. Data Sources. Electronic literature searches were conducted in Medline, Embase, PsycInfo and DARE databases from database inception to April 2010. Reference lists of selected articles were searched for further articles. Methods of Study Selection. Randomized controlled trials of psychological therapies in patients with CPP compared to no treatment, standard gynecological treatment or another form of psychological therapy. Two reviewers independently selected articles without language restrictions, and extracted data covering study characteristics, study quality and results. Reduction in pain, measured using visual analogue scales or other measurements, was the main outcome measure. Results. Of the 107 citations identified, four studies satisfied the inclusion criteria. Compared to no psychological intervention, therapy produced a standardized mean pain score of -3.27 (95% CI -4.52, -2.02) and 1.11 (95% CI -0.05, 2.27) at 3 months and -3.95 (95% CI -5.35, -2.55) and 0.54 (95% CI -0.78, 1.86) at 6 months and greater, based on a VAS score of 0-10. Conclusion. The current evidence does not allow us to conclude whether psychological interventions have an effect on self reported pain scores in women with CPP.