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The Relaxation Exercise and Social Support Trial (RESST): A community-based randomized controlled trial to alleviate medically unexplained vaginal discharge symptoms

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dc.contributor.author Kobeissi L.
dc.contributor.author Mahfoud Z.
dc.contributor.author Khoury B.
dc.contributor.author El Kak F.
dc.contributor.author Ghantous Z.
dc.contributor.author Khawaja M.
dc.contributor.author Nakkash R.
dc.contributor.author Ramia S.
dc.contributor.author Zurayk H.
dc.contributor.author Araya R.
dc.contributor.author Peters T.J.
dc.contributor.editor
dc.date Nov-2012
dc.date.accessioned 2017-10-05T16:04:44Z
dc.date.available 2017-10-05T16:04:44Z
dc.date.issued 2012
dc.identifier 10.1186/1471-244X-12-195
dc.identifier.isbn
dc.identifier.issn
dc.identifier.uri http://hdl.handle.net/10938/19656
dc.description.abstract Background: Symptoms such as medically unexplained vaginal discharge (MUVD) are common and bothersome, leading to potentially unnecessary use of resources.Methods: A community-based individually randomized controlled trial to assess the effectiveness of a relatively simple, culturally appropriate multi-component intervention on reducing reported MUVD, among women suffering from low-moderate levels of common mental distress. The setting was a socio-economically deprived, informal settlement in the southern suburbs of Beirut, Lebanon. The intervention comprised up to 12 group sessions implemented over a six-week period, each divided into a psychosocial and a relaxation exercise component. The primary outcome was self-reported MUVD, which was defined as a complaint of vaginal discharge upon ruling out reproductive tract infections (RTIs), through lab analysis. Anxiety and-or depression symptoms were the secondary outcomes for this trial. These were assessed using an Arabic validated version of the Hopkins Symptoms Checklist-25 (HSCL-25). Assessments were done at baseline and six months using face-to face interviews, pelvic examinations and laboratory tests. Women were randomized into either intervention or control group. Blinding on the intervention status was not possible for both logistic and ethical reasons, especially as knowledge of involvement in the intervention was integral to its delivery. Intent to treat analysis was used.Results: Of 75 women randomized to the intervention, 48percent reported MUVD at 6 months compared with 63percent of 73 in the control group (difference of -15percent, 95percent confidence interval (CI) -31percent, 0percent, p=0.067). Adjustments for baseline imbalances and any factors relating to consent had no appreciable effect on these results. The risk of MUVD was reduced in absolute terms by 2.4percent for each intervention session attended (95percent CI -4.9percent, 0.0percent, p=0.049). While there was also marginal evidence of a beneficial effect on anxiety, there was no evidence of mediation of the effect on MUVD through measures of common mental disorders.Conclusion: This study confirms that MUVD is an important public health problem. While the benefits of this intervention may appear modest, the intervention offers an opportunity for women to enhance their problem-solving skills as well as use physical relaxation techniques that can help them deal with stressful in their lives. Further research is needed in a variety of contexts, for different populations and preferably involving larger randomized trials of such an intervention.Trial registration: * Title of trial: The Relaxation Exercise and Social Support Trial. ISRCTN assigned: ISRCTN98441241. Date of assignation: 10-09-2010. Link: http:--www.controlled-trials.com-ISRCTN98441241. * Also registered at the Wellcome Trust register:. http:--www.controlled-trials.com-mrct-trial-469943-98441241. © 2012 Kobeissi et al.; licensee BioMed Central Ltd.
dc.format.extent
dc.language English
dc.publisher LONDON
dc.relation.ispartof Publication Name: BMC Psychiatry; Publication Year: 2012; Volume: 12;
dc.relation.ispartofseries
dc.relation.uri
dc.source Scopus
dc.subject.other
dc.title The Relaxation Exercise and Social Support Trial (RESST): A community-based randomized controlled trial to alleviate medically unexplained vaginal discharge symptoms
dc.type Article
dc.contributor.affiliation Kobeissi, L., Epidemiology and Biostatistics Division, Center for Middle Eastern Studies, University of Arizona, Tucson, Arizona, United States, Center for Research on Population and Health Epidemiology and Population Health, Dept. Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation Mahfoud, Z., Department of Public Health, Weill Cornell Medical College, Doha, Qatar
dc.contributor.affiliation Khoury, B., Department of Psychiatry-Faculty of Medicine, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation El Kak, F., Department of Health Promotion and Community Health Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation Ghantous, Z., Center for Research on Population and Health Epidemiology and Population Health, Dept. Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation Khawaja, M., Center for Research on Population and Health Epidemiology and Population Health, Dept. Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation Nakkash, R., Center for Research on Population and Health, Dept. of Health Promotion and Community Health Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation Ramia, S., Medical Lab Sciences Program Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation Zurayk, H., Center for Research on Population and Health Epidemiology and Population Health, Dept. Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation Araya, R., Academic Unit of Psychiatry School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
dc.contributor.affiliation Peters, T.J., School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
dc.contributor.authorAddress Khoury, B.; Department of Psychiatry-Faculty of Medicine, American University of Beirut, Beirut, Lebanon; email: bk03@aub.edu.lb
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Psychiatry;
dc.contributor.authorDepartment Psychiatry
dc.contributor.authorDivision
dc.contributor.authorEmail bk03@aub.edu.lb
dc.contributor.authorFaculty Faculty of Medicine
dc.contributor.authorInitials Kobeissi, L
dc.contributor.authorInitials Mahfoud, Z
dc.contributor.authorInitials Khoury, B
dc.contributor.authorInitials El Kak, F
dc.contributor.authorInitials Ghantous, Z
dc.contributor.authorInitials Khawaja, M
dc.contributor.authorInitials Nakkash, R
dc.contributor.authorInitials Ramia, S
dc.contributor.authorInitials Zurayk, H
dc.contributor.authorInitials Araya, R
dc.contributor.authorInitials Peters, TJ
dc.contributor.authorOrcidID
dc.contributor.authorReprintAddress Khoury, B (reprint author), Amer Univ Beirut, Dept Psychiat, Fac Med, Beirut, Lebanon.
dc.contributor.authorResearcherID
dc.contributor.authorUniversity American University of Beirut Medical Center
dc.description.cited Araya R, 2003, LANCET, V361, P995, DOI 10.1016-S0140-6736(03)12825-5; Bro Flemming, 1993, Scandinavian Journal of Primary Health Care, V11, P281, DOI 10.3109-02813439308994844; Chaaya MM, 2003, J PSYCHOSOM OBST GYN, V24, P175, DOI 10.3109-01674820309039671; Chaliha C, 1999, Int Urogynecol J Pelvic Floor Dysfunct, V10, P166, DOI 10.1007-s001920050039; Crook P, 1998, PHYSIOTHERAPY, V84, P366, DOI 10.1016-S0031-9406(05)61456-3; Deeb Mary E., 2003, Bulletin of the World Health Organization, V81, P639; Hawkes S, 1999, LANCET, V354, P1776, DOI 10.1016-S0140-6736(99)02463-0; HODGKISS AD, 1994, J PSYCHOSOM RES, V38, P3, DOI 10.1016-0022-3999(94)90003-5; Khan AA, 2003, PSYCHOSOMATICS, V44, P471, DOI 10.1176-appi.psy.44.6.471; Khawaja M, 2009, J WOMENS HEALTH, V18, P1701, DOI 10.1089-jwh.2008.0962; Kobeissi L, 2011, J COMMUN HEALTH, V36, P741, DOI 10.1007-s10900-011-9368-4; Kobeissi L, 2011, BMC PSYCHIATRY, V11, DOI 10.1186-1471-244X-11-142; Magliano L, 2002, ACTA PSYCHIAT SCAND, V106, P291, DOI 10.1034-j.1600-0447.2002.02223.x; Mahfoud Z, INT J ED PS IN PRESS; Mawajdeh Salah M, 2003, Health Care Women Int, V24, P635, DOI 10.1080-07399330390217734; Mead GE, 2009, COCHRANE DB SYST REV, V3, DOI DOI 10.1002-14651858.CD004366.PUB4.CD004366; MOUANOUTOUA VL, 1995, J PERS ASSESS, V64, P376, DOI 10.1207-s15327752jpa6402_16; Patel V, 2006, BRIT J PSYCHIAT, V189, P547, DOI 10.1192-bjp.bp.106.022558; Patel V, 2006, ARCH GEN PSYCHIAT, V63, P404, DOI 10.1001-archpsyc.63.4.404; Patel V, 2010, LANCET, V376, P2086, DOI 10.1016-S0140-6736(10)61508-5; Vikram Patel, 1999, Reproductive Health Matters, V7, P30, DOI 10.1016-S0968-8080(99)90004-6; Patel V, 2005, INT J EPIDEMIOL, V34, P853, DOI 10.1093-ije-dyi072; Prasad J, 2003, NATL MED J INDIA, V16, P303; Rahman A, 2008, LANCET, V372, P902, DOI 10.1016-S0140-6736(08)61400-2; Rannestad T, 2000, J WOMEN HEALTH GEN-B, V9, P897, DOI 10.1089-152460900750020937; SLOCUMB JC, 1989, GEN HOSP PSYCHIAT, V11, P48, DOI 10.1016-0163-8343(89)90025-X; Sumathipala A, 2008, BRIT J PSYCHIAT, V193, P51, DOI 10.1192-bjp.bp.107.043190; Talaat M, 2004, SOC SCI MED, V58, P515, DOI 10.1016-j.socscimed.2003.09.018; Van Buuren S, 1999, STAT MED, V18, P681, DOI 10.1002-(SICI)1097-0258(19990330)18:6681::AID-SIM713.0.CO;2-R; Veijola J, 2003, NORD J PSYCHIAT, V57, P119, DOI 10.1080-08039480310000941; ZURAYK H, 1995, STUD FAMILY PLANN, V26, P14, DOI 10.2307-2138047
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dc.identifier.articleNo 195
dc.identifier.coden BPMSC
dc.identifier.pubmedID 23140480
dc.identifier.scopusID 84871774055
dc.identifier.url
dc.publisher.address 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND
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dc.relation.ispartofConferenceCode
dc.relation.ispartofConferenceDate
dc.relation.ispartofConferenceHosting
dc.relation.ispartofConferenceLoc
dc.relation.ispartofConferenceSponsor
dc.relation.ispartofConferenceTitle
dc.relation.ispartofFundingAgency
dc.relation.ispartOfISOAbbr BMC Psychiatry
dc.relation.ispartOfIssue
dc.relation.ispartOfPart
dc.relation.ispartofPubTitle BMC Psychiatry
dc.relation.ispartofPubTitleAbbr BMC Psychiatry
dc.relation.ispartOfSpecialIssue
dc.relation.ispartOfSuppl
dc.relation.ispartOfVolume 12
dc.source.ID WOS:000313098400001
dc.type.publication Journal
dc.subject.otherAuthKeyword
dc.subject.otherChemCAS
dc.subject.otherIndex adult
dc.subject.otherIndex anxiety disorder
dc.subject.otherIndex article
dc.subject.otherIndex clinical effectiveness
dc.subject.otherIndex community trial
dc.subject.otherIndex controlled study
dc.subject.otherIndex depression
dc.subject.otherIndex distress syndrome
dc.subject.otherIndex female
dc.subject.otherIndex human
dc.subject.otherIndex interview
dc.subject.otherIndex laboratory test
dc.subject.otherIndex Lebanon
dc.subject.otherIndex major clinical study
dc.subject.otherIndex medically unexplained vagina discharge
dc.subject.otherIndex pelvic examination
dc.subject.otherIndex randomized controlled trial
dc.subject.otherIndex relaxation training
dc.subject.otherIndex self report
dc.subject.otherIndex social support
dc.subject.otherIndex socioeconomics
dc.subject.otherIndex vagina discharge
dc.subject.otherIndex Adolescent
dc.subject.otherIndex Adult
dc.subject.otherIndex Comorbidity
dc.subject.otherIndex Exercise Therapy
dc.subject.otherIndex Female
dc.subject.otherIndex Humans
dc.subject.otherIndex Lebanon
dc.subject.otherIndex Mental Disorders
dc.subject.otherIndex Middle Aged
dc.subject.otherIndex Poverty
dc.subject.otherIndex Psychiatric Status Rating Scales
dc.subject.otherIndex Psychotherapy, Group
dc.subject.otherIndex Questionnaires
dc.subject.otherIndex Social Support
dc.subject.otherIndex Treatment Outcome
dc.subject.otherIndex Vaginal Discharge
dc.subject.otherIndex Young Adult
dc.subject.otherKeywordPlus COMMON MENTAL-DISORDERS
dc.subject.otherKeywordPlus PRIMARY-CARE
dc.subject.otherKeywordPlus RISK-FACTORS
dc.subject.otherKeywordPlus PSYCHOLOGICAL DISTRESS
dc.subject.otherKeywordPlus REPRODUCTIVE HEALTH
dc.subject.otherKeywordPlus PELVIC PAIN
dc.subject.otherKeywordPlus LOW-INCOME
dc.subject.otherKeywordPlus WOMEN
dc.subject.otherKeywordPlus DEPRESSION
dc.subject.otherKeywordPlus INDIA
dc.subject.otherWOS Psychiatry


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