The Effect of Cognitive-Behavioral Therapy (CBT) on the Quality of Life and Psychological Fatigue in Women with Polycystic Ovarian Syndrome: A Randomized Control Trial

Abstract

Background: Given the increasing prevalence of complications caused by Polycystic Ovarian Syndrome (PCOS), including medical problems (obesity, diabetes, hirsutism, etc.) and psychological problems (anxiety and stress) and also chronicity of this disease, like other patients with chronic diseases, patients with PCOS experience lower quality of life and greater psychological fatigue. The present study was conducted to determine the effect of cognitive-behavioral therapy (CBT) on the quality of life and psychological fatigue (Primary outcomes), depression and BMI (Secondary outcomes) in women with polycystic ovarian syndrome. Methods: This randomized controlled clinical trial enrolled seventy-four 18-35-year-old women from the city of Saqez-Iran in 2016-17. Participants were assigned to CBT and control groups using block randomization. The intervention group received eight weekly sessions of 45-60 minutes of CBT. Questionnaires of depression, Polycystic Ovary Syndrome Health-Related Quality of Life (PCOSQ) and Fatigue Impact Scale (FIS) were completed before and four weeks after the intervention. The weight and height of women before intervention and the weight four weeks after the intervention were measured for calculating body mass index. Data were analyzed using ANCOVA test. Result: No significant difference was observed between the two groups before the intervention in terms of socio-demographic characterstics, and mean scores of quality of life, psychological fatigue, depression and body mass index (p>0.05). After the intervention, mean (standard deviation) of the quality of life score was 60.2 (13.3) in the intervention group and 24.4 (15) in the control, and according to ANCOVA test with baseline values controlled, mean score of quality of life was significantly higher in the intervention group compared to the control (adjusted mean difference: -33.1; Confidence Interval 95%= 37.8 to 28.5; p< 0.001). Mean (standard deviation) score of psychological fatigue was 28.2 (13.9) in the intervention group and 78.2 (37.1) in the control, and according to ANCOVA test with baseline values controlled, mental fatigue was significantly lower in the intervention group compared to the control. (-54.8; -24.0 to -65.6; p< 0.001). After intervention, the mean (SD) of depression score in the intervention group was 4.5 (3.9) and in the control group was 16.5 (8.6) while based on the ANCOVA test and the control of the baseline values, the mean depression score of the intervention group significantly was lower than in the control group (-13.8; -10.9 to -16.7; p< 0.001) BMI in the intervention group was 27.3 (5.4) and in the control group was 29.4 (5.5), which in the intervention group was significantly lower than the control group based on the ANCOVA test and through controlling the baseline values ( -0.6; -0.2 to -9; p< 0.001). Conclusion: Cognitive-behavioral group therapy is effective in improving quality of life, psychological fatigu depression and decreasing BMI in women with PCOS. Therefore, it is recommended to use this therapeutic approach to improve the physical and psychological health of women with polycystic ovarian syndrome.