Eight-session manualized cognitive behavioral therapy for anxiety and depression symptoms in perimenopause and postmenopause: a pilot study

OBJECTIVE: Mood and anxiety symptoms at the menopause transition are common. However, most cognitive-behavioral treatments focused on perimenopause center on managing physical symptoms such as hot flashes, and not mood symptoms. In this case series, we assessed the impact of a CBT intervention program on anxiety and depressive symptoms among individuals in perimenopause or postmenopause, who reported mood symptoms. METHODS: The intervention included eight 45-minute sessions of individual CBT with a clinical psychologist, and included CBT skills training (eg, behavioral activation, reframing negative automatic thoughts). The intervention was a general CBT intervention not tailored to perimenopause. Chart abstractions were performed for individuals who completed at least one session of the CBT program. RESULTS: Twenty participants completed at least one session, and sixteen completed all eight sessions. Symptoms of depression (Patient Health Questionnaire 9 scores) decreased by 42.1% from session 1 (M=8.74 [5.48]) to session 8 (M=5.06 [4.77]) (t=3.98, P=0.001). Similarly, symptoms of anxiety (GAD-7 scores) decreased by 56.2% from session 1 (M=6.98 [4.38]) to session 8 (M=3.06 [4.34]) (t=3.39, P=0.004). CONCLUSIONS: A standardized CBT intervention, not tailored to perimenopause, reduced depressive and anxiety symptoms in a small case cohort of women in perimenopause and postmenopause. Further research in a larger sample with a clinical trial design is needed.