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认知行为疗法对韩国围绝经期女性更年期症状及生活质量的疗效:一项前瞻性随机对照试验

Efficacy of cognitive behavioral therapy for menopausal symptoms and quality of life in Korean perimenopausal women: A pilot randomized controlled trial.

作者信息

Kim Da Seul, Kim Na Yeon, Han Doug Hyun, Kim Hee Jun, Yu Eun Seung, Kim Sun Mi

机构信息

Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.

Department of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.

出版信息

Maturitas. 2024 Nov;189:108103. doi: 10.1016/j.maturitas.2024.108103. Epub 2024 Aug 22.

Abstract

OBJECTIVES

Therapeutic interventions are crucial for perimenopausal women, given the challenging physical and psychological symptoms they face. This study focused on the development and verification of the efficacy of a cognitive behavioral therapy (CBT) protocol designed specifically for Korean perimenopausal women.

STUDY DESIGN

A CBT protocol for perimenopausal women was newly developed based on theory and evidence. Forty menopausal women were randomly assigned to either the CBT group (n = 19) or treatment-as-usual (TAU) group (n = 21). Participants in the CBT group underwent 60-min weekly sessions for eight weeks. The TAU group received standard care from gynecologists.

MAIN OUTCOME MEASURES

At baseline and follow-up, participants completed the Menopausal Rating Scale (MRS), World Health Organization Quality of Life Brief Version (WHOQOL-BREF), Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-15 (PHQ-15), Menopause Emotional Symptom Questionnaire (MESQ), and Subjective Memory Complaints Questionnaire.

RESULTS

The CBT group showed significant changes in their MRS (F = 4.18, p = .048), WHOQOL-BREF (7.60, 0.009), GAD-7 (4.61, 0.038), PHQ-15 (5.49, 0.025), and MESQ scores (7.19, 0.011) compared to the TAU group. In the CBT group, changes in GAD-7 scores were correlated with PHQ-15 (ρ = 0.57, p < .05), MESQ (0.57, < 0.05), and WHOQOL-BREF scores (-0.53, < 0.05).

CONCLUSION

CBT prevents the worsening of menopausal and emotional symptoms, anxiety, and quality of life. CBT may have had a therapeutic effect through the following mechanisms: managing anxiety by changing perceptions of menopause through education and training for coping with various menopausal symptoms and improving self-efficacy in symptom management.

CLINICAL TRIAL REGISTRATION NUMBER

KCT0007517.

摘要

目的

鉴于围绝经期女性面临的身体和心理症状具有挑战性,治疗干预措施对她们至关重要。本研究聚焦于专门为韩国围绝经期女性设计的认知行为疗法(CBT)方案的开发及疗效验证。

研究设计

基于理论和证据新开发了一种围绝经期女性的CBT方案。40名绝经女性被随机分为CBT组(n = 19)或常规治疗(TAU)组(n = 21)。CBT组的参与者每周接受60分钟的治疗,共持续八周。TAU组接受妇科医生的标准护理。

主要观察指标

在基线和随访时,参与者完成了绝经评定量表(MRS)、世界卫生组织生活质量简表(WHOQOL - BREF)、患者健康问卷 - 9、广泛性焦虑障碍量表 - 7(GAD - 7)、患者健康问卷 - 15(PHQ - 15)、绝经情绪症状问卷(MESQ)和主观记忆抱怨问卷。

结果

与TAU组相比,CBT组在MRS(F = 4.18,p = 0.048)、WHOQOL - BREF(7.60,0.009)、GAD - 7(4.61,0.038)、PHQ - 15(5.49,0.025)和MESQ评分(7.19,0.011)方面有显著变化。在CBT组中,GAD - 7评分的变化与PHQ - 15(ρ = 0.57,p < 0.05)、MESQ(0.57,< 0.05)和WHOQOL - BREF评分( - 0.53,< 0.05)相关。

结论

CBT可预防绝经及情绪症状、焦虑和生活质量的恶化。CBT可能通过以下机制产生治疗效果:通过教育和培训改变对绝经的认知来管理焦虑,应对各种绝经症状,并提高症状管理的自我效能感。

临床试验注册号

KCT0007517。

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