Internet-based Cognitive-behavioral Therapy for Premenstrual Syndrome: A Randomized Controlled Trial
Abstract Background: Premenstrual Syndrome (PMS) is a common problem among women of reproductive age, affecting various aspects of their lives. There are very limited studies investigating the effect of Internet-Based Cognitive-Behavioral Therapy (ICBT) on PMS. We aimed to investigate the effect of ICBT on symptom severity of women suffering from PMS and their quality of life in the perimenstrual and late follicular periods. Methods: Ninety-two university students aged 18-35 years with moderate to severe PMS were allocated into two groups of 46 using block randomization. The intervention group underwent ICBT for two menstrual cycles, while the control group received no intervention. All participants filled the Daily Record of Severity of Problems (DRSP) for two menstrual cycles and the Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form (Q-LES-Q-SF) on days 1-2 and 11-13 of the menstrual cycle pre- and post-intervention. Data were analyzed using univariate general linear models. Results: Four students in the intervention group were lost to follow-up. Post-interventionally, the mean score of total PMS symptoms was significantly lower in the intervention group than the control group (10.4 vs. 20.2, adjusted difference: -9.9 [95% CI: -13.3 to -6.6]) and perimenstrual quality of life was significantly higher (64.2 vs. 50.3, 14.1 [8.5 to 19.8]). However, there was no significant intergroup difference in the late follicular quality of life (68.3 vs. 67.3, 1.9 [-4.4 to 8.1]). Conclusions: Internet-Based Cognitive-Behavioral Therapy could effectively reduce PMS symptom severity and improve perimenstrual quality of life, with no significant effect on the late follicular quality of life. Trial registration: The Iranian Registry of Clinical Trials, Identifier: IRCT20100414003706N34, Registered 19 June 2019, https://www.irct.ir/trial/38394