Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
Cancer Med. 2022 Sep;11(18):3518-3528. doi: 10.1002/cam4.4709. Epub 2022 Mar 24.
Some studies did find significant differences in the level of depression of women while undergoing diagnostic evaluation of an abnormal Papanicolaou screening smear, but findings were not consistent. This study aimed to assess prevalence and correlates of depression in women with abnormal cervical screening results before and after diagnostic procedures.
A cross-sectional study was carried out during 2017 in a cohort of women with positive Papanicolaou screening test before and after diagnostic procedures (colposcopy/biopsy/endocervical curettage) at the university Clinical Centre Kragujevac, Serbia. Women completed a questionnaire about demographics, lifestyle, and other factors of interest. Also, questionnaire "Hospital Anxiety and Depression Scale" (HADS) was used immediately before and 2-4 weeks after the diagnostic procedures: a score of ≥8 on HADS-D and HADS-A subscales indicated depression and anxiety, respectively. Multivariate logistic regression was applied in the data analysis.
The study comprised 172 women, giving a response rate of 72.3%. The mean age of the participants was 47.8 ± 11.1 years (range 23-65). The frequency of depressive symptoms was significantly higher after diagnostic procedures (48.3%) than before diagnostic procedures (37.2%) (p = 0.038). Before diagnostic procedures, older age (OR = 1.60; 95% CI = 1.09-2.34; p = 0.017), and level of anxiety according to the HADS-A subscale (OR = 1.61; 95% CI = 1.38-1.88; p < 0.001) were significant independent predictors of depression. After diagnostic procedures, significant independent predictors of depression were urban place of residence (OR = 0.12; 95% CI = 0.03-0.47; p = 0.002) and level of anxiety according to the HADS-A subscale (OR = 1.85; 95% CI = 1.54-2.21; p < 0.001).
Our study showed that older age, rural residence, and anxiety play a role in shaping the risk of depression among women undergoing additional diagnostic procedures after receiving an abnormal Papanicolaou screening result.
一些研究确实发现，在对异常巴氏涂片筛查进行诊断评估期间，女性的抑郁程度存在显著差异，但研究结果并不一致。本研究旨在评估异常宫颈筛查结果女性在诊断前和诊断后出现抑郁的患病率和相关因素。
2017 年，在塞尔维亚克拉古耶瓦茨大学临床中心，对巴氏涂片筛查阳性的女性进行了一项横断面研究，这些女性在诊断程序（阴道镜检查/活检/宫颈刮宫术）前后完成了一份关于人口统计学、生活方式和其他感兴趣因素的问卷。还使用了问卷“医院焦虑和抑郁量表”（HADS）：HADS-D 和 HADS-A 子量表的得分≥8 分别表示抑郁和焦虑。数据分析采用多变量逻辑回归。
研究共纳入 172 名女性，应答率为 72.3%。参与者的平均年龄为 47.8±11.1 岁（范围 23-65 岁）。诊断后出现抑郁症状的频率明显高于诊断前（48.3% vs. 37.2%）（p=0.038）。诊断前，年龄较大（OR=1.60；95%CI=1.09-2.34；p=0.017）和 HADS-A 子量表的焦虑水平（OR=1.61；95%CI=1.38-1.88；p<0.001）是抑郁的显著独立预测因素。诊断后，抑郁的显著独立预测因素为城市居住地（OR=0.12；95%CI=0.03-0.47；p=0.002）和 HADS-A 子量表的焦虑水平（OR=1.85；95%CI=1.54-2.21；p<0.001）。
本研究表明，年龄较大、农村居住和焦虑在塑造异常巴氏涂片筛查结果后接受额外诊断程序的女性中出现抑郁的风险方面发挥作用。
