Narrative Analyses: Cognitive Behavior Group Therapy for Women with Menopause and Bipolar or Major Depressive Disorders

Abstract

Background: Bipolar and depressive disorders (bipolar disorder [BD], major depressive disorder [MDD]), as well as menopause affect millions of women. Although there are three known cognitive behavioral group treatment (CBGT) protocols to help women with problematic menopause symptoms, they do not target women on the BD or MDD spectrum. The purpose of this qualitative study was to learn more about the treatment needs and group experiences of women with problematic menopause symptoms and diagnosed on the BD and MDD spectrum, who participated in a CBGT intervention for menopausal symptoms. Methods: Narrative data recorded by clinicians (Interventionists' notes) and participants (Evaluation of Groups Survey) were analyzed using content analyses. Results: Several themes emerged from (n = 11 BD; n = 48 MDD) what women wanted help with (specific symptoms and general aspects of menopause), what women liked about CBGT (specific and general aspects of the program), and changes needed in the CBGT intervention (things wished for and barriers that interfered with the program). The two diagnostic groups differed in their responses, although both groups identified content and delivery gaps they wished would be addressed. Specifically related to their diagnosis, women most commonly talked about problems with worsening mood and mood instability and multiple stressors interfering with their ability to follow through with the intervention. Conclusions: These findings can help refine existing CBGT protocols for women diagnosed on the BD and MDD spectrum seeking help for menopause symptoms. Trial Registry: Parent study ClinicalTrials.gov [identifier: NCT02860910].

Keywords: bipolar disorder; cognitive behavioral group therapy; content analysis; major depressive disorder; menopause.

Conflict of interest statement

Dr. D.Y.C., Ms. D.O., Dr. S.D., Dr. C.B. and Dr. M.S.W. report no disclosures and no competing financial interests exist. Dr. J.S.C. reports personal fees from RoundGlass Inc., personal fees from Astellas Pharma Inc., personal fees from Kappa Sante, personal fees from Sojournix, personal fees from Mapi/ICON, and other from QUE oncology. Dr. M.M., reports royalties from American Psychiatric Publishing and grant funding from The Hartwell Foundation. Dr. M.S., in the last 3 years, has received research grants from Nuromate, Otsuka, Alkermes, International Society for Bipolar Disorders (ISBD), National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), and Patient-Centered Outcomes Research Institute (PCORI). She has been a consultant to Alkermes, Otsuka, Janssen, Myriad, Health Analytics, and Frontline Medical Communications. She has received royalties from Springer Press, Johns Hopkins University Press, Oxford Press, and UpToDate. She has received compensation for the preparation of continuing medical education (CME) Activities form Physician's Institute, MCM Education, CMEology, Potomac Center for Medical Education, Global Medical Education, and Creative Educational Concepts.

© Danette Conklin et al., 2021; Published by Mary Ann Liebert, Inc.