Cognitive-Behavioral and Pharmacological Interventions for Premenstrual Syndrome or Premenstrual Dysphoric Disorder: A Meta-Analysis

Maria Kleinstäuber, Johannes Gutenberg-University of Mainz
Michael Witthöft, Johannes Gutenberg-University of Mainz
Wolfgang Hiller, Johannes Gutenberg-University of Mainz


The current meta-analysis investigates the efficacy of psychotherapeutic interventions and psychopharmacotherapy for premenstrual syndrome (PMS) and premenstrual dysphoric disorder. Based on a multiple-phase literature search, controlled trials were selected according to a priori defined inclusion criteria. Data were extracted on the basis of a standardized coding scheme. The standardized weighted mean difference (random effects model) was used as effect size index. Dependent on outcome, 22 included studies obtained small to medium effect sizes for cognitive-behavioral interventions (range: d + = 0.24–0.70) and for serotonergic antidepressants (range: d + = 0.29–0.58), at post-assessment. Follow-ups were performed only in studies of cognitive-behavioral interventions (range: d + = 0.46–0.74). There was no evidence of a publication bias. For both cognitive-behavioral interventions and serotonergic antidepressants, efficacy in treatment of PMS was found to not be satisfactory. Future research should possibly focus more on a combination of both approaches.