Department of Psychiatry and Reproductive Biology, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Center for Value-based Care Research, Cleveland Clinic Foundation, Cleveland, OH, USA.
J Psychosom Res. 2020 Jan;128:109882. doi: 10.1016/j.jpsychores.2019.109882. Epub 2019 Nov 20.
This 6-week, prospective, single-arm study examined the feasibility, acceptability, and preliminary efficacy of cognitive behavioral group therapy in peri- and postmenopausal women with mood disorders (major depression or bipolar) and problematic vasomotor menopausal symptoms.
59 participants from an outpatient clinic with mood disorders and problematic vasomotor symptoms were enrolled. The primary outcomes were change from baseline to 6 weeks in Hot Flush Night Sweat Problem Rating, Hot Flash Related Daily Interference, and Quality of Life. Secondary outcomes were change in Hot Flush Frequency, depression, anxiety, perceived stress, anhedonia, beliefs and cognitive appraisals of menopause. ClinicalTrials.gov [identifier: NCT02860910].
On the Hot Flush Night Sweat Problem Rating, 39.3% improved 2 or more points, which was clinically relevant. Changes in Quality of Life (p = .001) and the Hot Flash Related Daily Interference Scale were also significant (p < .001). Significant results were found on most secondary outcomes (hot flush frequency on the Hot Flush Daily Diary, depression, anxiety, perceived stress (p < .001) and anhedonia (p = .001). One of six subscales (control subscale) on the cognitive appraisal of menopause significantly improved (p < .001). Three subscales on the beliefs measure did not change significantly (p = .05, p = .91, and p = .14). Six-week study retention was robust (N = 55, 93%) and 94.2% of individuals reported that cognitive behavioral group therapy sessions were useful.
This exploratory study suggests that CBGT is acceptable, feasible, and efficacious in women with mood disorders and problematic menopause vasomotor symptoms. Further studies are needed using more rigorous and controlled methods.
这项为期 6 周的前瞻性单臂研究探讨了认知行为团体治疗对伴有情绪障碍(重度抑郁症或双相情感障碍)和血管舒缩更年期症状的围绝经期和绝经后女性的可行性、可接受性和初步疗效。
从门诊就诊的伴有情绪障碍和血管舒缩更年期症状的 59 名患者中招募参与者。主要结局指标是从基线到 6 周时热潮红夜汗问题评分、热潮红相关日常干扰和生活质量的变化。次要结局指标为热潮红频率、抑郁、焦虑、感知压力、快感缺失、对更年期的信念和认知评估的变化。ClinicalTrials.gov [标识符:NCT02860910]。
在热潮红夜汗问题评分方面,39.3%的患者改善了 2 个或更多点,这具有临床意义。生活质量(p=0.001)和热潮红相关日常干扰量表的变化也具有显著意义(p<0.001)。大多数次要结局也有显著结果(热潮红日常日记中的热潮红频率、抑郁、焦虑、感知压力(p<0.001)和快感缺失(p=0.001)。更年期认知评估的六个子量表之一(控制子量表)显著改善(p<0.001)。信念量表的三个子量表没有显著变化(p=0.05,p=0.91,p=0.14)。为期 6 周的研究保留率稳健(N=55,93%),94.2%的参与者报告认知行为团体治疗课程有用。
这项探索性研究表明,CBGT 对伴有情绪障碍和血管舒缩更年期症状的女性是可接受、可行和有效的。需要进一步使用更严格和对照的方法进行研究。