The Effect of Cognitive-Behavioral Therapy on Stress and Anxiety of Women with Premature Ovarian Insufficiency: A Randomized Controlled Trial 2020

Abstract

Abstract Background: Women’s mental health is an important factor in community health. Due to the prevalence of psychological problems, the aim of this study was to determine the effect of cognitive-behavioral therapy (CBT) on stress and anxiety (primary outcomes) and self-esteem and depression (secondary outcomes) in women with premature ovarian insufficiency (POI). Methods: This randomized controlled trial was performed on 50 women known with premature ovarian insufficiency in infertility clinics in Tabriz-Iran, 2021. Participants were randomly assigned to CBT (n = 25) and control (n = 25) groups. CBT was provided in 8 sessions of 45-60 minutes once a week with 5 to 7 people. Spielberger State-Trait Anxiety, Cohen Perceived Stress, Beck Depression, and Rosenberg Self-Esteem questionnaires were used to collect data. Independent t-test and ANCOVA were used to compare the outcomes between the groups. Results: There was no statistically significant difference between the groups in terms of socio-demographic characteristics and baseline values of stress, anxiety, depression and self-esteem (P<0.05). After the intervention, based on ANCOVA test with adjusting the baseline values, mean scores of stress (adjusted mean difference (AMD): -10.97; 95% confidence interval (95% CI): -11.64 to -10.29; P<0.001), state anxiety (AMD: -14.76; 95% CI: -15.77 to -13.74; P<0.001), trait anxiety (AMD: -14.41; 95% CI: -15.47 to -13.74; P<0.001), and depression (AMD: -7.44; 95% CI: -8.41 to -6.46; P<0.001) were significantly lower in CBT group compared to the control group. Also, mean score of self-esteem (AMD: 1.49; 95 CI: 1.06 to 1.92; P<0.001) was significantly higher in CBT group compared to the control group. Conclusion: Regarding the effectiveness of CBT in reducing anxiety, stress, depression, and promoting self-esteem, it is recommended that health care providers use this method to improve mental health of women with POI. Trial registration: Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N64. Date of registration: 2/14/2021. URL: https://en.irct.ir/user/trial/52024/view; Date of first registration: 2/17/2021.