A 2-Year Follow-Up Study of Anxiety and Depression in Women Referred for Colposcopy After an Abnormal Cervical Smear

Abstract

OBJECTIVES: The aim of this study was to determine if there were any long-lasting elevated anxiety levels in women attending colposcopy after an abnormal cervical smear. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynaecology, Malmo University Hospital, Sweden. POPULATION: One hundred consecutive women were invited to participate when referred for colposcopy. METHODS: Women in the study group completed the State-Trait Anxiety Inventory, the Montgomery-Asberg Depression Rating Scale-self-rate (MADRS-S) and had a psychosocial interview prior to colposcopy at their two follow-up visits. MAIN OUTCOME MEASURES: State anxiety levels and depression scores at first visit, 6 months and 2 years. RESULTS: At follow up, levels of state anxiety and the depression scores of the women studied had decreased and were comparable to those of Swedish normative data. Two variables from the MADRS-S, 'ability to focus on different activities' and 'emotional involvement with others and in activities' were the most prominent for women with moderate to severe depression. At the 2-year visit, 30% of the women still had a fear of cancer. CONCLUSIONS: Referral for colposcopy after an abnormal cervical smear does not seem to result in long-lasting anxiety and depression. However, a subgroup of women, with the initially highest depression scores, still had at 2-year state anxiety levels and depression scores significantly higher than normal. Almost one-third of the women still had a fear of cancer in spite of lower 2-year state anxiety levels. (Less)