Hum. Reprod. Advance Access published online on June 21, 2007
Human Reproduction, doi:10.1093/humrep/dem167
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A randomized controlled trial of a cognitive-behavioural group intervention versus waiting-list control for women with uterovaginal agenesis (Mayer–Rokitansky–Küster–Hauser syndrome: MRKH)
1 The National Centre for Adolescent and Adult Women with Congenital Abnormalities of the Genital Tract, Queen Charlotte's and Chelsea Hospital, Du Cane Road, London W12 0HS, UK 2 Department of Counselling Psychology, City University, Northampton Square, London EC1V OHB, UK 3 Eating Disorder Research Unit, Institute of Psychiatry, PO Box 59, De Crespigny Park, London SE5 8AF, UK
4 Correspondence address. ‘Scaling Your Mountains’ Therapeutic Practice, 11 Gregory Street, The Attic Room, Sandy Bay Holistic Veterinary Centre, Sandy Bay, Hobart 7005, Tasmania, Australia. Tel: +61-3-6224-0855; Fax: +61-3-6224-4772; E-mail: scalingyourmountains{at}bigpond.com
BACKGROUND: Uterovaginal agenesis (Mayer–Rokitansky–Küster–Hauser syndrome: MRKH) is a congenital abnormality of the female genital tract, characterized by the non-formation of the vagina and uterus. There is a widespread agreement that MRKH has a lasting negative psychological impact on women with this condition, but as yet little is known about how to conceptualize and manage this. We developed a cognitive-behavioural group treatment (CBT) of MRKH. The aim of the present study was to determine whether this intervention, compared to waiting-list control, improves psychosocial outcomes in women with MRKH.
METHODS: After stratifying for age and type of MRKH (simple or complex), 39 women with MRKH were randomized to group CBT (n = 19) or waiting list (n = 20). Outcomes were assessed at pre-treatment, post-treatment (7 weeks) and at 3 months follow-up. The main outcome measure was the Symptom Check-List (SCL-90-R). Other outcomes included impact of event, self-esteem and interpersonal functioning.
RESULTS: Participants allocated to group CBT showed significantly reduced psychological symptoms on the SCL-90-R and non-significant improvements on all secondary outcomes at the end of treatment and follow-up, whereas those on the waiting list remained unchanged.
CONCLUSIONS: A group CBT intervention improves psychological outcomes in MRKH. This treatment may also be applicable to other gynaecological conditions.
Key words: cognitive-behavioural therapy/group treatment/Mayer–Rokitansky–Küster–Hauser syndrome/randomized controlled trial/uterovaginal agenesis
Submitted on September 7, 2006; resubmitted on May 12, 2007; accepted on May 16, 2007.