A 2-year follow-up study of anxiety and depression in women referred for colposcopy after an abnormal cervical smear.

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, Malmö 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.