Medical (fluoxetine) and psychological (cognitive–behavioural therapy) treatment for premenstrual dysphoric disorder
Abstract
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.
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CBT can reduce premenstrual anxiety and depression.
“The results of systematic review [10] and meta-analysis of randomized controlled trials [13, 14] suggest that cognitive behaviour therapy (CBT) can reduce premenstrual anxiety and depression, have a beneficial impact on behavioural change, and reduce interference of premenstrual symptoms on daily living [15, 16–18].”
CBT has a beneficial impact on behavioural change.
“The results of systematic review [10] and meta-analysis of randomized controlled trials [13, 14] suggest that cognitive behaviour therapy (CBT) can reduce premenstrual anxiety and depression, have a beneficial impact on behavioural change, and reduce interference of premenstrual symptoms on daily living [15, 16–18].”
The one-to-one intervention was based on a woman-centred PMDs CBT intervention previously demonstrated to be effective in reducing premenstrual distress in both a face-to-face and self-help modality.
“The one-to-one intervention was based on a woman-centred PMDs CBT intervention previously demonstrated to be effective in reducing premenstrual distress in both a face-to face [17] and self-help modality [56].”
CBT can reduce interference of premenstrual symptoms on daily living.
“The results of systematic review [10] and meta-analysis of randomized controlled trials [13, 14] suggest that cognitive behaviour therapy (CBT) can reduce premenstrual anxiety and depression, have a beneficial impact on behavioural change, and reduce interference of premenstrual symptoms on daily living [15, 16–18].”
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- Authors
- Hunter, M. S., Ussher, J. M., Cariss, M., Browne, S., Jelley, R., & Katz, M.
- Affiliations
- University College London (GB)
- Corresponding author
- Hunter, Myra S
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2002-09
- Volume
- 53
- Issue
- 3
- Pages
- 811-817
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W1574111772
- Cited by
- 70
- References
- 27
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 1 · 2019: 6 · 2018: 1 · 2017: 4 · 2016: 5 · 2015: 6 · 2014: 2 · 2013: 4 · 2012: 5
- FWCI
- 2.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Health Service Executive
- University College London
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- premenstrual dysphoric disorder, fluoxetine, cognitive behavioral therapy, premenstrual symptoms, coping strategies, causal attribution, biopsychosocial model, treatment outcome prediction, depressive mood, anxiety symptoms, treatment response
- MeSH terms
- Adaptation, Psychological, Administration, Oral, Adult, Anxiety Disorders, Female, Fluoxetine, Humans, Premenstrual Syndrome, Risk Factors, Cognitive Behavioral Therapy, Treatment Outcome, Selective Serotonin Reuptake Inhibitors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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