Razi Journal of Medical Sciences

fa مقایسه اثربخشی درمان فراتشخیصی و درمان‌ شناختی- رفتاری بر نشانگان پیش از قاعدگی زنان مبتلا به اختلالات خلقی شهر اصفهان Comparing the Effectiveness of Meta-Diagnostic Therapy and Cognitive-Behavioral Therapy on Premenstrual Symptoms of Women with Mood Disorders in Isfahan City روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: اختلالات خلقی گروه وسیعی از اختلالاتی را شامل می‌شوند که خلق مرضی (پاتولوژیک) و آشفتگی‌های مرتبط با آن، نمای بالینی غالب آنها را تشکیل می‌دهد لذا هدف از این پژوهش مقایسه اثربخشی درمان فراتشخیصی و درمان‌ شناختی- رفتاری بر نشانگان پیش از قاعدگی زنان مبتلا به اختلالات خلقی شهر اصفهان بود. روش کار: مطالعه حاضر یک طرح نیمه آزمایشی از نوع پیش آزمون- پس آزمون با گروه گواه به همراه دوره پیگیری بوده است. متغیرهای مستقل پژوهش حاضر عبارت بودند از دو روش درمان فراتشخیصی و درمان‌ شناختی- رفتاری و متغیرهای وابسته پژوهش نیز نشانگان پیش از قاعدگی بود که در جامعه زنان مبتلا به اختلالات خلقی شهر اصفهان مورد بررسی قرار گرفتند. جامعه پژوهش در این مطالعه عبارت از کلیه زنان مبتلا به اختلالات خلقی در شهر اصفهان بود. در این مطالعه 45 زن مبتلا به اختلالات خلقی مراجعه کننده به کلینیک‌های تخصصی شهر اصفهان در سال 1400، که واجد شرایط معیارهای ورود به مطالعه بودند و معیارهای خروج را نداشتند به صورت هدفمند انتخاب و در سه گروه (2 گروه آزمایشی و یک گروه گواه) مورد بررسی قرار گرفتند. اطلاعات بیماران از طریق اطلاعات دموگرافیک، پرسشنامه غربالگری اختلالات خلقی، پرسشنامه نشانگان پیش از  قاعدگی جمعآوری شد. پروتکل‌های درمانی شامل درمان شناختی رفتاری (هازلت-استیونز) و درمان فراتشخیصی (بارلو و همکاران،2011) بود. یافته‌ها: نتایج نشان داد که درمان فراتشخیصی و درمان‌شناختی رفتاری اثربخشی معنی داری بر نشانگان پیش از قاعدگی زنان مبتلا به اختلالات خلقی شهر اصفهان داشتند، اما یافته‌ها اختلاف معنی‌داری بین این دو گروه درمانی بر نشانگان پیش از قاعدگی نشان نداد. به طوری که درمان شناختی رفتاری به طور معنی‌داری اثربخشی بیشتری نسبت به درمان فراتشخیصی زنان مبتلا به اختلالات خلقی شهر اصفهان داشت. نتیجه‌گیری: نتایج این مطالعه نشان می‌دهد که هر دو درمان فراتشخیصی و درمان شناختی رفتاری می‌توانند در کاهش نشانگان پیش از قاعدگی زنان مبتلا به اختلالات خلقی مؤثر باشند. با این حال، درمان شناختی رفتاری به عنوان روشی با اثربخشی بیشتر توصیه می‌شود. این یافته بر اهمیت به‌کارگیری روش‌های متمرکز بر شناخت و رفتار برای مدیریت اختلالات خلقی تأکید دارد و می‌تواند در برنامه‌ریزی‌های درمانی مورد استفاده قرار گیرد.</div> <div style="text-align: justify;"> Background & Aims: The inevitable and heavy consequences of mood disorders and their recurring nature and heavy costs have caused this disorder to be considered among debilitating disorders and specialists pay special attention to the care and treatment of this disorder. Also, in recent years, more attention has been paid to psychotherapies, especially psychosocial interventions, along with drug therapy. Among these interventions, which are also based on the family, is the psychological education of the family. Mood disorders can cause changes in people's behavior and affect their ability to deal with usual activities such as work environment and living environment. Mood disorders are a major problem in public health and psychiatry due to their chronicity and recurring nature. Many factors can cause mood disorders in women. Premenstrual symptoms are a set of physical, psychological, emotional, and behavioral symptoms that occur periodically in the luteal phase of menstruation and significantly recede in the remainder of the cycle. It has been stated that premenstrual syndrome is a disease with a thousand faces; because doctors have attributed more than 150 symptoms to this disease. The symptoms of this disorder in women are different and this problem makes the diagnosis difficult. Worse, the pattern of this disease may change according to different months of the year and the age of the patient. Heartburn, mood instability, irritability, depression, nervous tension, tendency to cry, anxiety, headache, strong desire to eat sweets, increased appetite, heart palpitations, weakness, dizziness and fainting, weight gain, thirst, hot flashes, swelling of hands and feet, Swelling and tenderness of the breasts, feeling of swelling and bloating of the abdomen, joint and muscle pain, poor memory, insomnia, etc. are very common symptoms of this disease. Mood disorders include a wide group of disorders. That morbid (pathological) mood and disturbances related to it constitute their predominant clinical appearance, therefore this research aimed to compare the effectiveness of meta-diagnostic treatment and cognitive-behavioral therapy on premenstrual symptoms of women suffering from mood disorders in Isfahan City. Methods: The present study was a semi-experimental design of pre-test-post-test type with the control group and follow-up period. The independent variables of the present study were two methods of meta-diagnostic treatment and cognitive-behavioral therapy, and the dependent variables of the study were premenstrual symptoms, which were investigated in the community of women suffering from mood disorders in Isfahan City. The research population in this study consisted of all women with mood disorders in Isfahan city. In this study, 45 women with mood disorders referred to specialized clinics in Isfahan city in 1400, who qualified for the inclusion criteria and did not meet the exclusion criteria, were selected purposefully and divided into three groups (2 experimental groups and one control group). Patient information was collected through demographic information, mood disorder screening questionnaire, and premenstrual symptoms questionnaire. Treatment protocols included cognitive behavioral therapy (Hazelt-Stevens) and metadiagnostic therapy (Barlow et al., 2011). Results: The results showed that meta-diagnostic and cognitive-behavioral therapy had a significant effect on premenstrual symptoms in women with mood disorders in Isfahan City, but the findings did not show a significant difference between these two treatment groups on premenstrual symptoms. So cognitive behavioral therapy was significantly more effective than transdiagnostic treatment of women suffering from mood disorders in Isfahan City. Conclusion: The results of this study show that both meta-diagnostic therapy and cognitive behavioral therapy can reduce premenstrual symptoms in women with disorders. Be effective. However, cognitive behavioral therapy is recommended as a more effective method. This finding emphasizes the importance of using methods focused on cognition and behavior to manage mood disorders and can be used in treatment planning. be placed Studies have shown that women who suffer from PMS and PMD usually do not seek medical treatment. And in many cases, they don't get a proper answer even if they prefer. Also, researchers have concluded that drug treatments do not have much effect and long-term effectiveness on the psychological symptoms of this disorder. Considering the side effects of drug treatments, it is recommended to use them only in severe cases or in cases where the patient has not responded to other treatments; therefore, non-pharmacological treatments have been the focus of researchers in women suffering from menstrual disorders. Integrated meta-diagnostic treatment due to the limitation of existing specific cognitive-behavioral treatments and for people with emotional disorders, especially It is designed for mood and anxiety, and it uses the same treatment principles and protocols for all types of these disorders. The aforementioned treatment is a transdiagnostic cognitive-behavioral therapy focused on emotion; in this treatment, by emphasizing emotions and the adaptive and functional nature of emotions, we try to identify and correct non-adaptive efforts to regulate experiences. It becomes exciting. Also, integrated meta-diagnostic treatment has been able to have a positive effect on women's premenstrual symptoms in some studies.</div> درمان فراتشخیصی, درمان‌ شناختی- رفتاری, نشانگان پیش از قاعدگی, اختلالات خلقی Meta-diagnostic Treatment, Cognitive-Behavioral Therapy, Premenstrual Syndrome, Mood Disorders 1 12 http://rjms.iums.ac.ir/browse.php?a_code=A-10-5737-7&slc_lang=fa&sid=1 Zahra Akhondi Yazdi زهرا آخوندی یزدی 3900319475328460089987 3900319475328460089987 No PhD student, Department of psychology, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran. دانشجوی دکتری، گروه روانشناسی، واحد شهرکرد، دانشگاه آزاداسلامی، شهرکرد، ایران. Ahmed ghadanefri احمد غضنفری aghazan5@yahoo.com 3900319475328460089988 3900319475328460089988 Yes Associate Professor, Department of psychology, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran دانشیار، گروه روانشناسی، واحد شهرکرد، دانشگاه آزاد اسلامی، شهرکرد، ایران Tayebeh Sharifi طیبه شریفی 3900319475328460089989 3900319475328460089989 No Associate Professor, Department of psychology, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran. دانشیار، گروه روانشناسی، واحد شهرکرد، دانشگاه آزاد اسلامی، شهرکرد، ایران.