期刊
JOURNAL OF PSYCHOSOMATIC RESEARCH
卷 53, 期 3, 页码 811-817出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/S0022-3999(02)00338-0
关键词
cognitive-behavioural therapy; premenstrual symptoms; process; psychological; SSRIs; treatment
类别
Objectives: To investigate (i) the differential changes in premenstrual symptoms, mood, cognitions, and coping strategies during two treatments [cognitive - behavioural therapy (CBT) and fluoxetine] for premenstrual dysphoric disorder (PMDD) and (ii) the characteristics of those with good vs, poor outcome post treatment and at 1 year follow-up. Methods: Premenstrual symptoms, mood (Hospital Anxiety and Depression Scale, HADS), causal attributions, and use of cognitive and behavioural coping strategies were examined during 6 months of both treatments. The two treatment groups were then combined and divided on the basis of good vs. poor outcome posttreatment and at 1 year follow-up. Baseline measures were used to predict posttreatment outcome, and baseline and posttreatment measures were examined when attempting to predict outcome at 1 year follow-up. Results: Both treatments were equally effective at the end of 6 months (prospective daily diary measure). Fluoxetine treatment had a more rapid effect and greater impact upon anxiety symptoms, while CBT was associated with increased use of cognitive and behavioural coping strategies and a shift from a biomedical to a biopsychosocial causal attribution of premenstrual symptoms. Depressed mood at baseline assessment was associated with poorer response to both treatments. and learning active behavioural coping strategies was associated with a good outcome at 1 year follow-up. Conclusion: These results provide evidence of differential treatment effects of fluoxetine and CBT for PMDD and offer information that will enhance clinical decision-making. (C) 2002 Elsevier Science Inc. All rights reserved.
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