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

Abstract

To elucidate risk factors for high state anxiety in women referred for colposcopy. Prospective cohort study. Department of Gynaecology, Malmö University Hospital, Sweden. A total of 100 consecutive women referred for colposcopy for the first time after an abnormal cervical smear. 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. Variables related to high state anxiety were determined in bivariate and multiple logistic regression analysis. 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'. A depressive mood and the wording of the referral letter for colposcopy after an abnormal smear were predictive of high state anxiety levels.