title: Effectiveness of group and self-help cognitive behavior therapy in reducing problematic menopausal hot flushes and night sweats (MENOS 2):  a randomized controlled trial.
abstract: OBJECTIVE
  The aim of this study was to examine the effectiveness of group cognitive behavioral therapy (CBT) and guided self-help CBT in reducing hot flush and night sweat (HF/NS) problem rating at 6 and 26 weeks after randomization.
  
  
  METHODS
  This was a randomized control trial of 140 women having 10 or more problematic HF/NS a week for at least a month. The primary outcome was HF/NS problem rating (1-10) at 6 weeks after randomization. Secondary outcomes were physiologically measured HF/NS at 6 weeks; HF/NS problem rating at 6 weeks; and frequency, mood (Women's Health Questionnaire), and health-related quality of life (General Health Survey Short Form-36) at 6 and 26 weeks. Intention-to-treat analysis was used, and between-group differences were estimated using linear mixed models.
  
  
  RESULTS
  Baseline mean (SD) HF/NS weekly frequency was 63.15 (49.24), and problem rating was 5.87 (2.28). Group and self-help CBT both significantly reduced HF/NS problem rating at 6 weeks-group CBT versus no treatment control (NTC; adjusted mean difference, 2.12; 95% CI, 1.36-2.88; P < 0.001) and self-help CBT versus NTC (adjusted mean difference, 2.08; 95% CI, 1.29-2.86; P < 0.001)-and at 26 weeks-group CBT versus NTC (adjusted mean difference, 1.33; 95% CI, 0.54-2.13; P = 0.001) and self-help CBT versus NTC (adjusted mean difference, 1.19; 95% CI, 0.36-2.02; P = 0.005). Group and self-help CBT significantly reduced night sweat frequency at 6 and 26 weeks. There were improvements in mood and quality of life at 6 weeks and improved emotional and physical functioning for group CBT at 26 weeks.
  
  
  CONCLUSIONS
  These results suggest that CBT delivered in group or self-help format is an effective treatment option for women during the menopause transition and postmenopause with problematic HF/NS.
authors.affiliation: Department of Psychology (at Guy's), Institute of Psychiatry, King's College London, London, UK.
authors.forename: Beverley
authors.initials: B
authors.lastname: Ayers
authors.forename: Melanie
authors.initials: M
authors.lastname: Smith
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hellier
authors.forename: Eleanor
authors.initials: E
authors.lastname: Mann
authors.forename: Myra S
authors.initials: MS
authors.lastname: Hunter
mesh_terms: D000339:Affect; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D019584:Hot Flashes / Q000517:prevention & control*; D006801:Humans; D006945:Hyperhidrosis / Q000517:prevention & control*; D008593:Menopause; D008875:Middle Aged; D011615:Psychotherapy, Group; D011788:Quality of Life; D012648:Self Care; D011795:Surveys and Questionnaires; D016896:Treatment Outcome