A randomized comparison of psychological (cognitive behavior therapy), medical (fluoxetine) and combined treatment for women with premenstrual dysphoric disorder
Abstract
This study examines the relative effectiveness of cognitive behavior therapy (CBT) (ten sessions), fluoxetine (20 mg daily) and combined therapy (CBT plus fluoxetine) in women with premenstrual dysphoric disorder (PMDD). This was a randomized pragmatic treatment trial with three treatment cells. Treatment lasted for 6 months; a naturalistic follow-up was undertaken 1 year post-treatment. One hundred and eight women, satisfying the DSM-IV criteria for PMDD with 2 months' prospective confirmation were recruited into the study; sixty of these had completed 6 months of treatment and all measures before and after treatment. The main outcome measures were premenstrual scores on the Calendar of Premenstrual Experiences (COPE) and percentage of PMDD cases (DSM-IV diagnostic criteria). Significant improvement occurred in all three treatment-groups after 6 months' treatment, assessed by the COPE. Fluoxetine was associated with a more rapid improvement. There were no group differences in the percentage of DSM cases of PMDD post treatment, but at follow-up CBT was associated with better maintenance of treatment effects compared with fluoxetine. In conclusion, CBT and fluoxetine are equally effective treatments for PMDD, but the treatments have some differential effects that can be considered in treatment decisions. There appears to be no additional benefit of combining the treatments.
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Taking part in an intervention for PMDs can reduce psychological premenstrual symptoms and premenstrual distress.
“The finding of significant differences across time when the groups are collapsed (ignoring the intervention group assignment), confirms previous reports [10, 13, 14] that taking part in an intervention for PMDs can reduce psychological premenstrual symptoms and premenstrual distress [15, 16, 18, 20, 72, 73].”
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Premenstrual Experience Premenstrual Syndrome and Dysphoric Disorder
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Management of Premenstrual Dysphoric Disorder: A Scoping Review
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PREMENSTRUAL SENDROMUNUN TANI VE TEDAVİSİNDE KANIT TEMELLİ YAKLAŞIMLAR VE HEMŞİRELİK BAKIMI
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Premenstrual dysphoric disorder
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- Authors
- Hunter, M. S., Ussher, J. M., Browne, S. J., Cariss, M., Jelley, R., & Katz, M.
- Affiliations
- Guy's Hospital (GB)
- Western Sydney University (AU)
- University College London (GB)
- University College Hospital (GB)
- Corresponding author
- Hunter, M. S.
- Venue
- Journal of Psychosomatic Obstetrics & Gynecology
- Publisher
- Informa UK Limited
- Published
- 2002-01
- Volume
- 23
- Issue
- 3
- Pages
- 193-199
- ISSN
- 0167-482X (ISSN-L)
- 1743-8942
- OpenAlex
- W2100718469
- Cited by
- 128
- References
- 27
- Citations by year
- 2026: 8 · 2025: 3 · 2024: 4 · 2023: 7 · 2022: 8 · 2021: 3 · 2020: 5 · 2019: 4 · 2018: 1 · 2017: 8 · 2016: 5 · 2015: 9 · 2014: 8 · 2013: 6 · 2012: 4
- FWCI
- 4.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Obstetrics & Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- 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, cognitive behavioral therapy, fluoxetine, treatment effectiveness, maintenance of treatment effects, women's mental health
- MeSH terms
- Adult, Analysis of Variance, Combined Modality Therapy, Female, Fluoxetine, Humans, London, Middle Aged, Premenstrual Syndrome, Cognitive Behavioral Therapy, Selective Serotonin Reuptake Inhibitors
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