Effect of acceptance and commitment therapy on mood, sleep quality and quality of life in menopausal women: a randomized controlled trial

Abstract

Background One of the most critical periods in a woman’s life is menopause. During menopause, depression and anxiety are among the most common mood changes. Sleep disorders also increase during menopause, which leads to quality of life disorders. Different methods such as medication, psychotherapy, or a combination of them are used to treat these disorders. Acceptance and commitment-based therapy is one of the newest methods in psychotherapy that recently has been used a lot. Therefore, this study was conducted to determine the effect of acceptance and commitment therapy (ACT) on mood (primary outcome), sleep quality, and quality of life (secondary outcomes) of menopausal women. Methods This randomized controlled trial was performed on 86 menopausal women in Tabriz, Iran in 2021. Using the blocking method, participants were randomly assigned into the intervention and control groups. The intervention group received counseling based on ACT approach in 8 sessions of 60 to 90 min. The control group received only routine health care. Depression, Anxiety, Stress Scale-21 (DASS 21), Menopause Quality of Life (MENQOL), and Pittsburgh Sleep Quality Index (PSQI) questionnaires were completed before intervention and immediately after the intervention. Independent t-test and Mann-Whitney U test were used to compare the outcomes between the two groups. Results In terms of sociodemographic characteristics and baseline values of the studied variables, there was no statistically significant difference between the study groups before the intervention. At the end of the intervention, the mean (SD: standard deviation) scores of anxiety, stress, and depression in the counseling group were 2.66 (1.28), 2.91 (1.62), and 1.98 (1.59) and in the control group were 4.19 (1.85), 5.61 (1.49) and 3.59 (1.91). In the intervention group, the mean score of all three variables was significantly lower than the control group (P < 0.001). After the intervention, the mean (SD) of the total sleep quality score was 4.04 (2.52) in the counseling group and 4.13 (2.63) in the control group. In addition, the mean (SD) of the total quality of life score was 23.47 (20.13) in the counseling group and 23.14 (17.76) in the control group. Between the study groups, there were no statistically significant differences in the mean of the overall score of sleep quality (P = 0.867) and the overall score of quality of life (P = 0.759). Conclusion Using ACT-based counseling can improve the mood of menopausal women. However, further randomized clinical trials are needed before making a definitive conclusions. Trial registration Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N65. Date of registration: 2/19/2021. Date of first registration: 2/19/2021. URL: https://en.irct.ir/user/trial/53544/view; Date of recruitment start date: 2/22/2021.

The effects of mindfulness-based interventions on anxiety, depression, stress, and mindfulness in menopausal women: A systematic review and meta-analysis

“…The interventions were all based on mindfulness and ranged in duration from 8 to 12 weeks, with interventions ranging from 0.5 to 5 hours per week. Except for Fu-Zhen Zhong ( 27 ), Chattha et al ( 34 ), and Monfaredi et al ( 35 ), all experimental groups adopted the method of group training combined with individual training. Four studies ( 29 – 32 ) further subdivided training methods into formal and informal training methods.…”

“…Informal methods include detecting pleasant and unpleasant events, detecting breathing, eating, walking, and other daily activities. The control group received wait-list ( 27 , 29 , 31 – 33 , 36 , 38 ), menopause hormone therapy ( 28 ), routine health care ( 30 , 35 ), menopause education control ( 9 ), and easy body movements ( 34 ). Outcome indicators included anxiety, depression, stress, and mindfulness scores.…”

“…Among the 13 RCTs included, participants were randomly grouped in all the included studies, but only the specific random allocation sequence generation method was described in five studies ( 9 , 33 – 36 ) that employed computer software; two studies ( 28 , 30 ) used a random number table; and one study ( 37 ) used the random drawing method for random grouping. Three studies ( 33 , 35 , 36 ) used sealed and opaque envelopes with serial numbers; one study ( 37 ) used boxes; and one study ( 34 ) used a central random allocation system for hiding distribution. In Wong's study ( 9 ), a statistician who was not part of the research team performed random number generation and allocation.…”

“…Seven existing studies ( 27 – 30 , 33 , 35 , 36 ) recruited 551 menopausal women (270 in the experimental group and 281 in the control group) to evaluate the effects of MBIs on anxiety scores in menopausal women using the STAI, GAD-7, SAS, HADS, DASS 21, and bPOMS, respectively. SMD was used to deal with numerical variables due to different evaluation tools.…”

“…However, there is no consistent data on its effectiveness in improving anxiety, depression, stress, and mindfulness in menopausal women. Several studies have shown that MBIs can significantly reduce anxiety, depression, and stress scores ( 27 – 35 ), while some studies did not have statistically significant results ( 9 , 36 ). Some studies have shown that interventions significantly enhanced mindfulness scores ( 33 , 37 , 38 ), while other studies showed no significant effect of interventions on mindfulness scores ( 9 ).…”