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Psychological Intervention for Premenstrual Syndrome: A Meta-Analysis of Randomized Controlled Trials

Busse J.W.a · Montori V.M.d · Krasnik C.b · Patelis-Siotis I.c · Guyatt G.H.a ·
aDepartment of Clinical Epidemiology and Biostatistics, bDepartment of Medical Science, Psychiatry and Behavioural Neuroscience, and cDepartment of Psychiatry, McMaster University, Hamilton, Ont., Canada; dKnowledge and Encounter Research Unit, Division of Endocrinology, Diabetes, Metabolism, Nutrition, and Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minn., USA Psychother Psychosom 2009;78:6–15 (DOI:10.1159/000162296)


Background: We conducted a systematic review and meta-analysis to determine the efficacy of psychological interventions for premenstrual syndrome. Methods: We systematically searched and selected studies that enrolled women with premenstrual syndrome in which investigators randomly assigned them to a psychological intervention or to a control intervention. Trials were included irrespective of their outcomes and, when possible, we conducted meta-analyses. Results: Nine randomized trials, of which 5 tested cognitive behavioural therapy, contributed data to the meta-analyses. Low quality evidence (design and implementation weaknesses of the studies, possible reporting bias) suggests that cognitive behavioural therapy significantly reduces both anxiety (effect size [ES] = –0.58; 95% confidence interval [CI] = –1.15 to –0.01; number needed to treat [NNT] = 5), and depression (ES = –0.55; 95% CI = –1.05 to –0.05; NNT = 5), and also suggests a possible beneficial effect on behavioural changes (ES = –0.70; 95% CI = –1.29 to –0.10; NNT = 4) and interference of symptoms on daily living (ES = –0.78; 95% CI = –1.53 to –0.03; NNT = 4). Results provide much more limited support for monitoring as a form of therapy and suggest the ineffectiveness of education. Conclusions: Low quality evidence from randomized trials suggests that cognitive behavioural therapy may have important beneficial effects in managing symptoms associated with premenstrual syndrome.


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