مداوای علائم وازوموتور به منظور تشخیص زنان مبتلا به اختلالات خلقی
Abstract
1- Objective
2- Methods
3- Primary outcomes
4- Secondary outcomes
5- Results
6- Discussion
7- Limitations and future research
8- Relevance to clinical practice
References
Abstract
Objective: 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. Methods: 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]. Results: 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. Conclusion: 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.
Objective
Menopause can be an important life transition for women. Physical symptoms may include vasomotor symptoms and irregular menstrual cycles [1]. Vasomotor symptoms also referred to as hot flashes and night sweats (HFNS), are the primary reason why women seek medical attention during menopause. Racial minorities, women with higher BMIs [2–4] and women with lower education levels [4] may be more vulnerable to menopause distress. There is an important link between psychological status and menopause associated with stress, anxiety, or depression [5,6]; and menopause may exacerbate psychiatric symptoms in those with pre-existing mental health conditions. The Study on Women's Health Across the Nation (SWAN) suggested that peri- and early postmenopausal women were at two-to-four-times greater risk for depressive episodes even after controlling for demographic and clinical characteristics [7]. Other risk factors for menopausal symptoms include stressful life events, psychological distress [8,9], higher perceived stress [10], depressive symptoms and negative affect [11]. Negative beliefs about menopause and vasomotor symptom severity have been associated with depressed symptoms during menopause [12,13].