ABSTRACT
Approximately 10% of women are severely affected by premenstrual syndrome (PMS) during their reproductive years. Several biological theories of causation have been proposed and each has provoked treatment attempts through medication to little sustained effect. As many of the reported complaints are psychological, a new treatment approach was considered using cognitive-behavioral therapy. A preliminary study which combined cognitive-behavioral therapy with drug treatment produced considerable symptom reduction. The present study examined the efficacy of cognitive-behavioral therapy alone in direct comparison with hormone treatment. Relaxation instructions were provided to a control group. Initial rapid responses to drug treatment and relaxation diminishes after 2 months, together with marked attrition in the control group. Significant positive benefits from cognitive-behavioral therapy were achieved after the first treatment month that continued throughout and were maintained at follow-up 3 months later. Implications for future management are discussed.
Subject(s)
Adaptation, Psychological , Cognitive Behavioral Therapy , Dydrogesterone/administration & dosage , Premenstrual Syndrome/psychology , Premenstrual Syndrome/therapy , Relaxation Therapy , Adaptation, Psychological/drug effects , Adult , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Personality InventoryABSTRACT
This study compared findings of a community group of women (n = 32), who claimed they did not require help for menstrual cycle complaints, with a patient group (n = 75) with confirmed premenstrual syndrome (PMS). Subjects completed a battery of psychological tests to identify personality characteristics, levels of depression, anxiety, stress and marital adjustment. Menstrual cycle symptoms were assessed with the Menstrual Distress Questionnaire (MDQ, Moos, 1985) during follicular (day 6-8) and premenstrual phases (day 26-28) of two adjusted cycles and with daily symptom ratings. Daily 24-h urines were collected for oestradiol and pregnanediol levels for one cycle. After prospective assessment, the non-clinical sample were differentiated into those with pronounced cyclical symptom changes (Hi-volunteers, n = 13) and others with minimal cyclical changes (Lo-volunteers, n = 19). The total non-clinical sample could be distinguished from the patient group on depression, stress, and self-esteem scores. The non-clinical subgroup with pronounced cyclical symptoms is proposed as an 'at-risk' group for future treatment seeking.
