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Menopausal DepressionCBTMENONCT02480192

Cognitive Behavioural Therapy for Menopausal Symptoms

A study testing CBT for Menopausal Symptoms (CBT-Meno) in people with Menopausal Depression, run by St. Joseph's Healthcare Hamilton at 1 site in Canada.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study examined the effectiveness of a new cognitive-behavioural therapy for menopausal symptoms (CBT-Meno). Half of participants were randomly assigned to the 12-week CBT-Meno program and half to a 12-week waitlist. Read more about this study

Who is it for?
Ages 40 to 65 years, women only
Conditions the study is for
Menopausal Depression
What is being tested?
CBT for Menopausal Symptoms (CBT-Meno)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
72 participants
Where
1 siteCanada
Study dates
1 Jun 2015to 30 Apr 2018
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 to 65 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Menopausal staging: perimenopause or postmenopausal as per STRAW definitions (Harlow et al., 2012) or having surgically-induced menopause
  • A minimum of mild level of severity of depressive symptoms (defined by the Beck Depression Inventory, scores of 14 or greater during initial screen),
  • Significant vasomotor symptoms: i.e., vasomotor symptoms that are (a) frequent (≥ 4 hot flashes per day/night or 21 or more per week); (b) distressing (≥ 3 or more on the vasomotor subscale of the Greene Climacteric Scale); and (c) interfering (≥ 30 or greater on the Hot Flash Related Daily Interference Scale).
  • Not taking hormonal, anti-depressant, or any herbal therapies or if taking these medications they must be taking a stable dose for at least three months prior to the study and for the duration of the study,
  • Speak, read, and write in English sufficiently to comprehend testing procedures and written materials in group treatment.

Who cannot join

  • Participants who are severely depressed/suicidal at the time of the screen or intake assessment that would warrant acute treatment and hence, render them unable to act as a wait list control participant if randomized to this condition,
  • Participants with Psychotic Disorders, or current Substance Dependence.

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • Women's Health Concerns, St. Joseph's Hospital

    Hamilton, Ontario

Other trials in Canada

About this study

Official title: Cognitive Behavioural Therapy for Menopausal Symptoms: A Randomized Controlled Trial

This study examined the effectiveness of a new cognitive-behavioural therapy for menopausal symptoms (CBT-Meno). Half of participants were randomly assigned to the 12-week CBT-Meno program and half to a 12-week waitlist. Common menopause symptoms (i.e., hot flashes/night sweats, depression, anxiety, poor sleep, and sexual concerns) were assessed at baseline, 12-weeks post-baseline, and (for women in the CBT-Meno condition) at 3-month follow-up.

Read the detailed description

Women going through the menopausal transition often experience adverse physical changes (e.g., hot flashes/night sweats, sleep difficulties, sexual concerns) in addition to emotional difficulties (e.g., depression, anxiety) that can significantly impact functioning and overall quality of life. To date, hormone therapy (HT) has been the most commonly used treatment to relieve symptoms of menopause. However, reports have questioned the safety of HT long-term (e.g., risk of heart attacks, strokes, cancer) for some women. Cognitive-behavioural therapy (CBT), has been proposed as a low-risk treatment for menopausal symptoms. The investigators developed a comprehensive non-pharmacological, CBT for menopausal symptoms (CBT-Meno), published the treatment manual (Green, McCabe, \& Soares, 2012), and obtained initial evidence supporting the effectiveness of CBT-Meno in a single-sample pilot study (Green et al., 2013). The goal in the study reported here was to conduct a larger randomized controlled trial to evaluate the effectiveness of the CBT-Meno program compared to a waitlist condition. The investigators hypothesized that participants would experience less intense/disruptive hot flashes/night sweats, reduced depression and anxiety, improvement in sleep difficulties, and sexual concerns. The investigators also predicted that these benefits would be maintained at 3-month follow-up and that participants would report high treatment satisfaction.

Being tested
CBT for Menopausal Symptoms (CBT-Meno)
Keywords
Vasomotor, Symptoms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CBT for Menopausal Symptoms (CBT-Meno)Other

    This 12-week CBT-based group treatment program consists of a combination of components including: a) psychoeducation about the nature of menopause including examination about thoughts and beliefs, b) cognitive and behavioural modification related to vasomotor symptoms, c) cognitive-behavioural strategies for depression, e) cognitive-behavioural strategies for anxiety and panic, d) sleep hygiene and cognitive-behavioural strategies for sleep difficulties, f) psychoeducation and lifestyle and behavioural modifications for urogenital complaints, and g) psychoeducation and cognitive-behavioural strategies for sexual concerns.

Study groups in NCT02480192
Study groupRoleWhat they receive
Experimental Group (CBT-Meno)ExperimentalAfter an initial assessment, the experimental group received 12 weekly sessions (2 hours each) of group-based cognitive-behavioural therapy for menopausal symptoms (CBT-Meno) (up to n=8 per group). Symptoms that were targeted included vasomotor symptoms (hot flashes/night sweats), depressive symptoms, anxiety, poor sleep, and sexual concerns. Participants were re-assessed at 12-weeks post-baseline and at 3 months post-treatment.
Receives: Other: CBT for Menopausal Symptoms (CBT-Meno)
WaitlistNo interventionAfter an initial assessment, the waitlist comparison group did not receive any treatment for 12 weeks. They were then re-assessed at 12-weeks post-baseline and this data was used to compare this group to the experimental group to determine the effectiveness of the CBT-Meno treatment. After this re-assessment participants in the waitlist condition were offered the same CBT-Meno treatment as the experimental group: 12 weekly sessions (2 hours long) of cognitive-behavioural therapy for menopausal symptoms.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The Hot Flash Related Daily Interference Scale

    The Hot Flash Related Daily Interference Scale assesses the degree to which vasomotor functions interfere with daily life (Carpenter, 2001). The current study aims to explore whether CBGT for menopausal symptoms significantly reduces vasomotor function daily interference, as captured by the Hot Flash Related Daily Interference Scale, compared to pre-treatment and wait-list controls.

    Measured: 12 weeks

  2. The Beck Depression Inventory

    The Beck Depression Inventory is a multiple choice questionnaire which measures depressive symptoms (Beck, Steer \& Brown, 1996). The current study aims to explore whether CBGT for menopausal symptoms significantly reduces subjective depressive symptoms, compared to pre-treatment and wait-list controls.

    Measured: 12 weeks

Secondary outcomes (20)
  1. The Greene Climacteric Scale - Vasomotor Subscale

    The Greene Climacteric Scale is a self-report questionnaire which measures four menopause-related domains: Vasomotor symptoms, depression and anxiety, physical complaints, and sexual concerns (Greene, 1998). The current study aims to explore whether CBGT for menopausal symptoms significantly improves typical menopausal symptoms, as captured by the Greene Climacteric Scale, compared to pre-treatment and wait list controls?

    Measured: 12 weeks

  2. The Montgomery-Asberg Depression Rating Scale

    The Montgomery-Asberg Depression Rating Scale (Montgomery \& Asberg, 1979) is a measure that requires an interview format assessing depressive symptoms in menopausal women and contains a global severity score. The current study aims to explore whether CBGT for menopausal symptoms significantly reduces menopausal depressive symptoms, as captured by the Montgomery-Asberg Depression Rating Scale, compared to pre-treatment and wait-list controls.

    Measured: 12 weeks

  3. The Hamilton Anxiety Scale

    The Hamilton Anxiety Scale is an interview format rating scale developed to quantify the severity of anxiety symptomatology and contains a global score (Hamilton, 1956). The current study aims to explore whether CBGT for menopausal symptoms significantly improves objective anxiety symptoms, as captured by the Hamilton Anxiety Scale, compared to pre-treatment and wait list controls.

    Measured: 12 weeks

  4. The Pittsburgh Sleep Quality Inventory

    The Pittsburgh Sleep Quality Inventory (Buysee et al, 1989) is a self-report inventory that contains seven component scores along with one global score indicating overall sleep quality. The current study aims to explore whether CBGT for menopausal symptoms significantly improves sleep disruption, as captured by the Pittsburgh Sleep Quality Inventory, compared to pre-treatment and wait list controls.

    Measured: 12 weeks

  5. Ambulatory Sternal Skin-Conductance Monitoring

    Vasomotor symptoms will be assessed objectively through ambulatory sternal skin-conductance monitoring which will be worn for 2 consecutive days prior to each assessment. The current study aims to explore whether CBGT for menopausal symptoms significantly reduces vasomotor symptoms (hot flashes/night sweats) compared to pre-treatment and wait-list controls.

    Measured: 12 weeks

  6. Female Sexual Functioning Index

    Assesses sexual concerns (e.g., arousal, desire, satisfaction) over the past month

    Measured: 12 weeks

  7. The Greene Climacteric Scale - Sexual Concerns

    The GCS includes an item that assesses sexual concerns in the past week

    Measured: 12 weeks

  8. The Utian Quality of Life Scale

    Quality of life will be assessed through The Utian Quality of Life Scale (Utian et al, 2002) is a self-report questionnaire which contains four domains namely, occupational, health, emotional, and sexual in addition to a total score representing quality of life. The current study aims to explore whether CBGT for menopausal symptoms significantly improves quality of life compared to pre-treatment and wait list controls.

    Measured: 12 weeks

  9. Dysfunctional Attitudes Scale (DAS)

    The Dysfunctional Attitudes Scale (DAS; Weissman, 1979) will be used to assess common beliefs about the self, others, and the future that are considered risk factors of depressive symptoms.

    Measured: 12 weeks

  10. Depression Anxiety Stress Scale (DASS)

    The Depression Anxiety Stress Scale (DASS; Lovibond \& Lovibond, 1995) is a self-report questionnaire that assesses three negative emotional states using three scales (depression scale, anxiety scale, and stress scale). The DASS will be used to explore whether CBGT for menopausal symptoms significantly reduces depressive, anxious, and stress related symptoms, as captured by the DASS, compared to pre-treatment and wait-list controls.

    Measured: 12 weeks

  11. Clinical Global Impression Scale (CGI)

    Global severity of illness and change in clinical condition will be assessed using the Clinical Global Impression Scale (CGI; Guy, 1976). The current study aims to explore whether CBGT for menopausal symptoms significantly improves global illness severity, as captured by the CGI, compared to pre-treatment and wait-list controls.

    Measured: 12 weeks

  12. Beck Anxiety Inventory (BAI)

    Changes in subjective somatic or panic-related symptoms of anxiety will be assessed using the Beck Anxiety Inventory (BAI; Beck, 1993). The current study aims to explore whether CBGT for menopausal symptoms significantly reduces anxiety symptoms, as captured by the BAI, compared to pre-treatment and wait-list controls.

    Measured: 12 weeks

  13. Hot Flash Rating Scale: Frequency & Problem Rating Scale (HFRS-FP)

    Changes in frequency of and distress related to hot flashes will be assessed using the Hot Flash Rating Scale: Frequency \& Problem Rating Scale (HFRS-FP; Hunter \& Liao, 1995). The current study aims to explore whether CBGT for menopausal symptoms reduces the frequency and distress of hot flashes, as captured by the HFRS-FP, compared to pre-treatment and wait-list controls.

    Measured: 12 weeks

  14. Hot Flash Behaviour Scale (HFBehS)

    Changes in behavioural reactions to menopausal hot flashes and night sweats will be assessed using the Hot Flash Behaviour Scale (HFBehS; Hunter \& Ayers, 2011). The current study aims to explore whether CBGT for menopausal symptoms has an impact on behavioural reactions to menopausal vasomotor symptoms (hot flashes/ night sweats), as captured by the HFBehS, compared to pre-treatment and wait-list controls.

    Measured: 12 weeks

  15. Born Steiner Irritability Scale

    The Born Steiner Irritability Scale (Born et al., 2004) is a female specific, self-report measure that will be used to assess changes in irritability (annoyance, anger, tension, hostility, and sensitivity to noise and touch). The current study aims to examine whether CBGT for menopausal symptoms is effective in significantly reducing irritability as captured by the Born Steiner Irritability scale, compared to pre-treatment and wait-list controls.

    Measured: 12 weeks

  16. Menopause Representation Questionnaire (MRQ)

    Cognitions about menopause including those about identity, consequences, time frame and perceptions of control and cure will be assessed using the Menopause Representation Questionnaire (MRQ; Hunter \& Dea, 2010). The current study aims to explore whether CBGT for menopausal symptoms has an impact on cognitions about menopause, as captured by the MRQ, compared to pre-treatment and wait-list controls.

    Measured: 12 weeks

  17. Hot Flash Belief Scale (HFBS)

    Thoughts associated with the menopausal experience of hot flushes and night sweats will be assessed using the Hot Flash Belief Scale (HFBS; Rendall et al. 2008). The current study aims to explore whether CBGT for menopausal symptoms has an impact on beliefs and thoughts associated with hot flushes and night sweats, as captured by the HFBS, compared to pre-treatment and wait-list controls.

    Measured: 12 weeks

  18. Anxiety Sensitivity Index-3 (ASI-3)

    Changes in anxiety sensitivity will be measured using the Anxiety Sensitivity Index-3 (ASI-3; Taylor et al., 2007). The current study aims to explore whether CBGT for menopausal symptoms significantly reduces fear of anxiety-related situation, as captured by the ASI-3, compared to pre-treatment and wait-list controls.

    Measured: 12 weeks

  19. Couples Satisfaction Index (CSI-32)

    Changes in relationship satisfaction will be assessed using the Couples Satisfaction Index (CSI-32; Funk \& Rogge, 2007). The current study aims to explore whether CBGT for menopausal symptoms improves relationship satisfaction, as captured by the CSI-32, compared to pre-treatment and wait-list controls.

    Measured: 12 weeks

  20. Client Satisfaction Questionnaire (CSQ)

    Participant satisfaction with the CGBT for menopausal symptoms treatment will be assessed using the Client Satisfaction Questionnaire (CSQ; Larsen et al., 1979).

    Measured: 12 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Jun 2015 (estimated)
  2. Study start1 Jun 2015
  3. Primary completion30 Apr 2018
  4. Study completion30 Apr 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
A single-blind, randomized controlled trial was conducted to assess the effectiveness of the CBT-Meno program compared to a waitlist comparison condition.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
72 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02480192
Sponsor's protocol ID
OMHF-SG1
Acronym
CBTMENO
Status last verified
Mar 2019
First submitted
22 May 2015
Last updated
13 Mar 2019
Results posted
No
Data monitoring committee
No

Publications

  • Donegan E, Frey BN, McCabe RE, Streiner DL, Fedorkow DM, Furtado M, Green SM. Impact of the CBT-Meno protocol on menopause-specific beliefs, dysfunctional attitudes, and coping behaviors. Menopause. 2022 Aug 1;29(8):963-972. doi: 10.1097/GME.0000000000002003.

    PubMed 35881942
  • Green SM, Donegan E, McCabe RE, Fedorkow DM, Streiner DL, Frey BN. Objective and subjective vasomotor symptom outcomes in the CBT-Meno randomized controlled trial. Climacteric. 2020 Oct;23(5):482-488. doi: 10.1080/13697137.2020.1737929. Epub 2020 Apr 17.

    PubMed 32299247

Questions about this trial

What is this clinical trial studying?

A study testing CBT for Menopausal Symptoms (CBT-Meno) in people with Menopausal Depression, run by St. Joseph's Healthcare Hamilton at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 13 Mar 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The Hot Flash Related Daily Interference Scale (time frame: 12 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02480192, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Mar 2019.

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