Psychological Intervention for Premenstrual Syndrome: A Meta-Analysis of Randomized Controlled Trials

Background: Given the high prevalence of clinically relevant premenstrual symptoms and the associated impairment, there is a need for effective treatments. Initial evidence suggests cognitive-behavioural therapy (CBT) as an effective treatment for premenstrual dysphoric disorder (PMDD). The aim of the current randomized clinical trial was to evaluate an Internet-based CBT (iCBT) to reduce the burden of PMDD. Methods: In all, 174 women with PMDD were recruited via newspaper articles, flyers, and social media. They were randomized to a treatment group (TG; n = 86) or waitlist control group (CG; n = 88). Women of the TG received an 8-week therapist-guided iCBT. Data were assessed before and after treatment/waiting, and 6 months after intervention with prospective symptom diaries and questionnaires in the premenstrual phase. Treatment effects and moderators were analysed using hierarchical linear modelling. Results: Significant time × group interaction effects on functional impairment and psychological impairment, impact on everyday life, symptom intensity, and symptom disability in favour of the TG indicated the efficacy of the treatment. Follow-up assessments demonstrated treatment effects to be stable until 6 months after treatment. Additionally, significant interactions with moderator variables were found. In the TG, higher levels of active coping and lower levels of support-seeking coping were associated with stronger improvement in interference in everyday life and symptom intensity. In addition, lower levels of perceived stress were associated with stronger improvement in functional impairment. Conclusion: The iCBT was highly effective in reducing the burden of PMDD. It appears to be particularly important to address coping styles and stress management in the treatment.

Section: Discussionmentioning

confidence: 99%

“…Cognitive-behavioural therapy (CBT) is the psychological approach with the best evidence of efficacy. Two previous meta-analyses have reported promising results for CBT based on 5 [21] or 6 controlled trials [22]. However, the methodological quality of these trials is rather low.…”

Section: Introductionmentioning

confidence: 99%

Internet-Based Cognitive-Behavioural Intervention for Women with Premenstrual Dysphoric Disorder: A Randomized Controlled Trial

Weise

Kaiser

Janda

et al. 2019

“…Effect size can be conservatively grouped according to Cohen [30] as small (0.2), medium (0.5) or large (0.8). For an easier interpretation, we further transformed effect sizes of the main outcomes into numbers needed to treat (NNT) according to the procedure of Busse et al [31] (based on the results of Norman et al [32]) and presented them additionally as odds ratios (OR).…”

Section: Methodsmentioning

confidence: 99%

Effects of Interventions Involving the Family in the Treatment of Adult Patients with Chronic Physical Diseases: A Meta-Analysis

Hartmann

Bäzner

Wild

et al. 2010

231

185

Background: Families can have considerable influence on the health of a patient with a chronic physical disease, and attempts have been made to optimise treatment by involving family members. This meta-analysis aimed to systematically assess the effects of family-oriented interventions on adults with chronic physical diseases. Methods: A systematic literature search was conducted to identify randomised clinical trials that have evaluated the effects of family-based interventions for adult patients compared to standard treatment. Interventions were classified as psychoeducation or addressing family relationships. The outcomes studied were the patient’s physical and mental health and the health of the family members. The effect sizes were calculated as Hedges’ g and combined using random-effects models. Results: Fifty-two relevant randomised controlled trials (including 8,896 patients) were extracted. The main disease groups were cardiovascular diseases including stroke, cancer and arthritis. Meta-analysis showed that family involvement resulted in significantly better health than standard treatment for all outcomes. The mean overall effect sizes were 0.32 for the patients’ physical health, 0.28 for the patients’ mental health and 0.35 for the family members’ health. Overall, the effects were not large, but they were broad, significant and stable over a long period of time. There was a tendency towards higher effects in favour of relationship-focused family interventions compared to educational interventions. Conclusions: Psychosocial interventions involving family members in the treatment of chronic physical diseases have positive effects on the health outcome for both the patient and his/her family. Further high-quality research is necessary to investigate differential effects.

“…Recent studies have shown the efficacy of psychological therapies in different medical illnesses [13,14,15,16]. Some investigations have been carried out which focus on the psychological aspect of lupus, with the aim of reducing the disease’s interference in the daily life of patients [17], improving social support and patients’ levels of self-management [18,19,20] and developing coping skills in patients [21].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Cognitive Behavioural Therapy for the Treatment of Chronic Stress in Patients with Lupus Erythematosus: A Randomized Controlled Trial

Navarrete‐Navarrete

Peralta-Ramírez

Sabio-Sánchez

et al. 2010

Background: Chronic stress worsens the quality of life (QOL) of lupus patients by affecting their physical and psychological status. The effectiveness of a cognitive-behavioural intervention in a group of patients with lupus and high levels of daily stress was investigated. Methods: Forty-five patients with lupus and high levels of daily stress were randomly assigned to a control group (CG) or a therapy group (TG); they received cognitive behavioural therapy (CBT) which consisted of ten consecutive weekly sessions. The following variables were evaluated at baseline and at 3, 9 and 15 months: (1) stress, anxiety, depression, (2) Systemic Lupus Erythematosus Disease Activity Index, somatic symptoms, number of flares, (3) anti-nDNA antibodies, complement fractions C3 and C4 and (4) QOL. A multivariate analysis of repeated measures and various analyses of variance were carried out. Results: We found a significant reduction in the level of depression, anxiety and daily stress in the TG compared to the CG and a significant improvement in QOL and somatic symptoms in the TG throughout the entire follow-up period. We did not find any significant changes in the immunological parameters. Conclusions: CBT is effective in dealing with patients suffering from lupus and high levels of daily stress as it significantly reduces the incidence of psychological disorders associated with lupus and improves and maintains patients’ QOL, despite there being no significant reduction in the disease activity index.