Background/ObjectiveCurrent guidelines recommend biopsychosocial‐informed treatment for chronic pelvic pain (CPP). The objective of this systematic review was to describe the available biopsychosocial approaches for the treatment of CPP, and the outcomes reported, to understand how guideline‐recommended treatments can be applied.Search StrategyMEDLINE, CINAHL, PsycINFO, EMBASE, Emcare, AMED and Cochrane trial registries were searched (inception to 17 November 2023).Selection CriteriaCPP Studies in women where the principal treatment modality was a biopsychosocial approach were included. Prospero registration: CRD42022374256.Data Collection/AnalysisData extraction included study setting, population, study design, intervention characteristics and outcome measures and is described via a narrative synthesis.ResultsThe review included 14 RCTs (871 patients) and identified four broad intervention categories (Acceptance Commitment Therapy n = 2, Cognitive Behavioural Therapy n = 6, Mindfulness‐based approaches n = 2, and Physiotherapy‐based interventions n = 4). Pain science education (PSE) and, exposure/engagement with valued activity were recognised as important aspects of treatment regardless of intervention type. The most utilised outcomes were pain reduction and emotional functioning, with all studies reporting improvements in these domains. Heterogeneity in outcomes prevented efficacy comparison. High risk of bias was identified in six studies (1/4 physiotherapy‐based approaches, 2/6 CBT, 1/2 ACT and 2/2 mindfulness‐based interventions).ConclusionsCBT and ACT‐based biopsychosocial approaches were found effective in reducing pain and improving psychometric outcomes for CPP. Evaluation indicated PSE, and exposure/engagement in valued activity are important components of biopsychosocial management. Outcome heterogeneity needs to be addressed in future trials.

中文翻译：

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女性慢性盆腔疼痛管理的生物心理社会方法：系统评价


背景/目标当前指南推荐对慢性盆腔疼痛 （CPP） 进行生物心理社会知情治疗。本系统综述的目的是描述治疗 CPP 的可用生物心理社会方法和报告的结局，以了解如何应用指南推荐的治疗。检索策略检索策略MEDLINE、CINAHL、PsycINFO、EMBASE、Emcare、AMED和Cochrane试验注册库（建库至2023年11月17日）。纳入排除标准纳入主要治疗方式为生物心理社会方法的女性 CPP 研究。Prospero 注册：CRD42022374256。数据收集/分析资料提取包括研究环境、人群、研究设计、干预特征和结局测量，并通过叙述性综合进行描述。结果本综述包括 14 项 RCT （871 名患者） 并确定了四大干预类别 （接受承诺疗法 n = 2、认知行为疗法 n = 6、基于正念的方法 n = 2 和基于物理治疗的干预 n = 4）。无论干预类型如何，疼痛科学教育 （PSE） 和接触/参与有价值的活动都被认为是治疗的重要方面。最常用的结局是减轻疼痛和情绪功能，所有研究都报告了这些领域的改善。结局的异质性阻碍了疗效比较。在六项研究中确定了高偏倚风险 （1/4 基于物理治疗的方法、2/6 CBT、1/2 ACT 和 2/2 基于正念的干预）。结论发现基于 CBT 和 ACT 的生物心理社会方法可有效减轻 CPP 的疼痛和改善心理测量结果。 评估表明 PSE 和暴露/参与有价值的活动是生物心理社会管理的重要组成部分。结局异质性需要在未来的试验中得到解决。