A prospective Swedish cohort study on psychosocial factors influencing anxiety in women referred for colposcopy

Abstract

Objectives: To elucidate risk factors for high state anxiety in women referred for colposcopy.

Design: Prospective cohort study.

Setting: Department of Gynaecology, Malmö University Hospital, Sweden.

Population: A total of 100 consecutive women referred for colposcopy for the first time after an abnormal cervical smear.

Methods: Women in the study group completed prior to colposcopy the State-Trait Anxiety Inventory, the Montgomery-Asberg Depression Rating Scale-self-rate, and were interviewed about their psychosocial situation.

Main outcome measures: Variables related to high state anxiety were determined in bivariate and multiple logistic regression analysis.

Results: High depression scores and the wording of the referral letter for colposcopy were related to high state anxiety in a multivariate analysis. Women with high depression scores had a nine-fold risk for higher levels of state anxiety and did not respond with lower state anxiety levels after information and examination. Women who received a letter stating 'some changes' were at a five-fold increased risk for high levels of state anxiety than those who received a letter stating 'light changes'.

Conclusion: A depressive mood and the wording of the referral letter for colposcopy after an abnormal smear were predictive of high state anxiety levels.