Effectiveness of group and self-help cognitive behavior therapy in reducing problematic menopausal hot flushes and night sweats (MENOS 2): a randomized controlled trial

被引:143
作者
Ayers, Beverley [1 ]
Smith, Melanie [1 ]
Hellier, Jennifer [2 ]
Mann, Eleanor [1 ]
Hunter, Myra S. [1 ]
机构
[1] Kings Coll London, Dept Psychol Guys, Inst Psychiat, London SE1 9RT, England
[2] Kings Coll London, Mental Hlth & Neurosci Clin Trials Unit, Inst Psychiat, London SE1 9RT, England
来源
MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY | 2012年 / 19卷 / 07期
关键词
Hot flushes; Night sweats; Menopause; Cognitive behavior therapy; Group; Self-help; Vasomotor symptoms; ESTROGEN PLUS PROGESTIN; NONHORMONAL THERAPIES; POSTMENOPAUSAL WOMEN; VASOMOTOR SYMPTOMS; HORMONE-THERAPY; FLASHES; MEMORY; MIDLIFE; INTERVENTIONS; QUESTIONNAIRE;
D O I
10.1097/gme.0b013e31823fe835
中图分类号
R71 [妇产科学];
学科分类号
100211 [妇产科学];
摘要
Objective: The aim of this study was to examine the effectiveness of group cognitive behavioral therapy (CBT) and guided self-help CBT in reducing hot flush and night sweat (HF/NS) problem rating at 6 and 26 weeks after randomization. Methods: This was a randomized control trial of 140 women having 10 or more problematic HF/NS a week for at least a month. The primary outcome was HF/NS problem rating (1-10) at 6 weeks after randomization. Secondary outcomes were physiologically measured HF/NS at 6 weeks; HF/NS problem rating at 6 weeks; and frequency, mood (Women's Health Questionnaire), and health-related quality of life (General Health Survey Short Form-36) at 6 and 26 weeks. Intention-to-treat analysis was used, and between-group differences were estimated using linear mixed models. Results: Baseline mean (SD) HF/NS weekly frequency was 63.15 (49.24), and problem rating was 5.87 (2.28). Group and self-help CBT both significantly reduced HF/NS problem rating at 6 weeks-group CBT versus no treatment control (NTC; adjusted mean difference, 2.12; 95% CI, 1.36-2.88; P < 0.001) and self-help CBT versus NTC (adjusted mean difference, 2.08; 95% CI, 1.29-2.86; P < 0.001)-and at 26 weeks-group CBT versus NTC (adjusted mean difference, 1.33; 95% CI, 0.54-2.13; P = 0.001) and self-help CBT versus NTC (adjusted mean difference, 1.19; 95% CI, 0.36-2.02; P = 0.005). Group and self-help CBT significantly reduced night sweat frequency at 6 and 26 weeks. There were improvements in mood and quality of life at 6 weeks and improved emotional and physical functioning for group CBT at 26 weeks. Conclusions: These results suggest that CBT delivered in group or self-help format is an effective treatment option for women during the menopause transition and postmenopause with problematic HF/NS.
引用
收藏
页码:749 / 759
页数:11
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