Washington University School of Medicine, St Louis, MO, USA.
J Low Genit Tract Dis. 2011 Jan;15(1):42-7. doi: 10.1097/LGT.0b013e3181e66a82.
To explore the previously reported associations between cervical squamous lesions and psychologic measures of stress and depression.
In a multicenter cohort study, women with HIV and HIV-seronegative women had Pap tests and completed self-report questionnaires including the Perceived Stress Scale-10 (PSS), which measures perceived stress, the Posttraumatic Stress Disorder (PTSD) Checklist-Civilian Version (PCL-C), which measures symptoms of PTSD, and the Center for Epidemiologic Studies Depression (CES-D) scale, which measures depressive symptoms.
Median scores were 13 (range = 0-38) for the PSS, 24 (range = 17-85) for the PCL-C, and 8 (range = 0-57) for the CES-D, indicating moderate stress and minimal depression. For PSS, compared with women in the lowest tertile of reported stress, the odds ratios (ORs) for squamous intraepithelial lesions (SIL) were 0.88 (95% confidence interval [CI] = 0.50-1.54) for women in the middle tertile and 0.96 (95% CI = 0.54-1.68) for women in the highest tertile. For PCL-C, compared with women in the lowest tertile of PTSD symptoms, ORs for SIL were 0.79 (95% CI = 0.43-1.41) for women in the middle tertile and 1.17 (95% CI = 0.68-2.01) for women in the highest tertile. Rates of SIL were similar for CES-D scores 16 or higher (compared with women with lower scores; OR = 1.41, 95% CI = 0.88-2.26) and 23 or higher (OR = 1.39, 95% CI = 0.81-2.40). In the multivariable analysis including the number of sexual partners, age, income, ethnicity, and serostatus, stress as measured by PSS and PCL-C and depressive symptoms as measured by CES-D remained unassociated with SIL.
We found no evidence that stress and depression affect the prevalence of cervical squamous lesions.
探讨先前报道的宫颈鳞状病变与压力和抑郁的心理测量指标之间的关系。
在一项多中心队列研究中，HIV 阳性和 HIV 阴性的女性均接受巴氏涂片检查，并完成包括 10 项感知压力量表（PSS）、创伤后应激障碍检查表-平民版（PCL-C）和流行病学研究中心抑郁量表（CES-D）在内的自我报告问卷。
PSS 得分中位数为 13（范围 0-38），PCL-C 得分中位数为 24（范围 17-85），CES-D 得分中位数为 8（范围 0-57），表明存在中等程度的压力和轻度抑郁。对于 PSS，与报告压力最低三分位的女性相比，压力处于中间三分位的女性患鳞状上皮内病变（SIL）的比值比（OR）为 0.88（95%置信区间 [CI] = 0.50-1.54），而压力处于最高三分位的女性的 OR 为 0.96（95% CI = 0.54-1.68）。对于 PCL-C，与 PTSD 症状最低三分位的女性相比，症状处于中间三分位的女性患 SIL 的 OR 为 0.79（95% CI = 0.43-1.41），而症状处于最高三分位的女性的 OR 为 1.17（95% CI = 0.68-2.01）。CES-D 评分≥16（与评分较低的女性相比；OR = 1.41，95% CI = 0.88-2.26）和≥23（OR = 1.39，95% CI = 0.81-2.40）时 SIL 发生率相似。在包括性伴侣数量、年龄、收入、种族和血清状态的多变量分析中，PSS 和 PCL-C 测量的压力以及 CES-D 测量的抑郁症状与 SIL 均无关联。
我们没有发现压力和抑郁会影响宫颈鳞状病变的发生率的证据。
