1
|
Déa CA, Moreira ECH, Zamboti CL. Sexual function, quality of life, anxiety, and depression in women of reproductive age using hormonal, nonhormonal, and no contraceptive methods. J Sex Med 2024:qdae060. [PMID: 38842258 DOI: 10.1093/jsxmed/qdae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Hormonal contraceptive use has been related to adverse effects, including impacts on sexual function and sexual satisfaction, although the difference in the effects on sexual function with the use of hormonal vs nonhormonal contraceptive methods remains controversial. AIM In this study we sought to compare the prevalence of dyspareunia, sexual function, sexual satisfaction, quality of life, anxiety, and depression between women using hormonal, nonhormonal, or no contraceptive methods and to compare these outcomes between the most frequently used contraceptive methods. METHODS This cross-sectional study included sexually active women of reproductive age who were stratified into 3 groups: women using hormonal, nonhormonal, or no contraceptive methods. Based on the use of questionnaires administered to the study participants, we compared sexual function in the 3 groups and more specifically among users of oral contraceptives, copper and hormonal intrauterine devices, and barrier methods. OUTCOMES Participants completed 4 questionnaires to assess sexual function (Female Sexual Function Index), sexual satisfaction (Sexual Quotient-Feminine Version), quality of life (12-item Medical Outcomes Short Form Health Survey), and anxiety and depression (Hospital Anxiety and Depression Scale). RESULTS This study included 315 women classified into 3 groups on the basis of contraceptive use: 161 in the hormonal contraceptives group (median [interquartile range] age, 24 [23-28] years), 97 in the nonhormonal contraceptives group (age 26 [23-30] years), and 57 in the no contraceptive methods group (age 28 [24-35] years). Dyspareunia prevalence showed no difference between the groups. In the quality of life domain, compared with women in the nonhormonal contraceptive group, women in the hormonal contraceptive group were younger and had lower sexual function satisfaction, reduced arousal, and heightened pain (P < .05), as well as higher anxiety and depression levels (P = .03, for both), increased pain (P = .01), and poorer overall health (P = .01). No difference was found between these groups in other quality of life domains. Regarding contraceptive methods, women using copper intrauterine devices had better sexual function, including higher rates of arousal and lower anxiety, than women using oral contraceptives (P < .05). CLINICAL IMPLICATIONS The results of this study highlight worse sexual function and sexual satisfaction and higher levels of anxiety and depression in women using hormonal contraceptive methods than in women using nonhormonal methods. STRENGTHS AND LIMITATIONS The findings of this study strengthen the evidence of differences in sexual function between women using oral contraceptives and those using copper intrauterine devices. Sexual function was also compared among users of oral contraceptives, copper and hormonal intrauterine devices, and barrier methods. However, less frequently used contraceptive methods, such as hormonal injections and vaginal rings, could not be compared in this sample. CONCLUSION Women using hormonal contraceptive methods were younger, had lower sexual function and satisfaction, and experienced higher anxiety and depression levels than women using nonhormonal contraceptive methods.
Collapse
Affiliation(s)
- Caroline Andrade Déa
- Department of Physiotherapy, State University of Londrina, Londrina, Paraná 86038-350, Brazil
| | | | - Camile Ludovico Zamboti
- Department of Physiotherapy, State University of Londrina, Londrina, Paraná 86038-350, Brazil
- Department of Physical Therapy, School of Science and Technology of Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo 19060-900, Brazil
| |
Collapse
|
2
|
Ilic I, Babic G, Dimitrijevic A, Grujicic Sipetic S, Ilic M. Predictors of Anxiety Before and After Diagnostic Procedures in Women with Abnormal Papanicolaou Smear in Cervical Cancer Screening Program. Behav Med 2024; 50:118-129. [PMID: 36268786 DOI: 10.1080/08964289.2022.2132202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/02/2022]
Abstract
Anxiety is one of the most common causes of withdrawal from follow-up among women with abnormal Papanicolaou screening results. The purpose of this study was to investigate predictors of anxiety in women with abnormal Papanicolaou smear in cervical cancer screening program. A population-based, cross-sectional study concerning the factors related to anxiety was carried out during 2017 in a cohort of women (N = 172) with positive Papanicolaou screening test before and after diagnostic procedures (colposcopy/biopsy/endocervical curettage) at one university Clinical Center in Serbia. Women completed a socio-demographic questionnaire and scale concerning anxiety (Hospital Anxiety and Depression Scale, subscale HADS-Anxiety) immediately before and 2-4 weeks after the diagnostic procedures. Multivariate logistic regression was applied in the data analysis. In our study, 35.2% (n = 52) of women had abnormal anxiety scores before the diagnostic procedures and 40.1% (n = 69) after the diagnostic procedures. Predictors of anxiety before diagnostic procedures were family history of noncervical gynecological cancers, higher level of worry and high burden of depressive symptoms. Significant independent predictors of anxiety after diagnostic procedures in women were rural residence, tension and discomfort during medical procedures, and less satisfaction with information/support. Although there was no significant difference in the prevalence of anxiety before and after diagnostic procedures in women with abnormal Papanicolaou screening results, results of this research will enable doctors to successfully make decisions concerning timely psychological support for women with positive screening test for cervical cancer that is necessary to decrease anxiety in our population.
Collapse
Affiliation(s)
- Irena Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Goran Babic
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Aleksandra Dimitrijevic
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | | | - Milena Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| |
Collapse
|
3
|
Suša R, Ratinac M, Ćupurdija V, Novković L, Milojević-Ilić M, Petrović M, Igrutinović N, Vuleta M, Timotijević L, Kostić O, Čekerevac I. Implementation of the Baveno Classification in Obstructive Sleep Apnea and Its Correlation with Symptoms of Anxiety and Depression. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1938. [PMID: 38003986 PMCID: PMC10673059 DOI: 10.3390/medicina59111938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: The Baveno classification represents a new approach to the assessment of the severity of OSA (Obstructive sleep apnea), which takes significant comorbidities into account: atrial fibrillation, arterial hypertension, heart failure, stroke, diabetes mellitus, and OSA symptoms expressed through the Epworth sleepiness scale (ESS). The authors believe that the Baveno classification facilitates a better stratification of patients with OSA and can be a good guide for deciding on the therapeutic approach and clinical monitoring of patients with OSA, compared to the AHI (apnea-hypopnea index) itself. The aim of this paper is to confirm the advantage of applying the Baveno classification to the evaluation of symptoms of anxiety and depression in the OSA patients compared to the application of the AHI as a single parameter. Materials and Methods: This research represents an observational retrospective study that was performed at the Pulmonology Clinic of the University Clinical Center in Kragujevac, Serbia. The study sample included 104 patients with diagnosed OSA. Patients were divided into four categories retrogradely according to the Baveno classification (A, B, C, and D). Statistical data processing was performed using the IBM SPSS Statistics version 25.0 program. Results: In our study, we proved that the Baveno classification is better at predicting the depressive disorder in OSA patients compared to the AHI itself, according to abnormal BDI-II (Beck Depression Inventory) score (value greater than ten) and HADS-D (Hospital anxiety and depression) scale (value greater than eight). The average AHI in the entire group of examined patients was 44.3 ± 19.8, while in category A the average AHI was 25.2 ± 10, in category B, 53.4 ± 20.6; in category C, 38.2 ± 18.5; and in category D, 48.1 ± 19.2. In the total sample, AHI did not correlate with the depressive episodes, but individually, the highest frequency of the depressive symptoms was precisely in the categories with the highest AHI (group D and B), where more than half of the subjects had an abnormal score. The frequency of the anxiety disorder (HADS-A) between the analyzed groups did not differ significantly, although the largest number of patients with significant anxiety were in category B, according to the Baveno classification. Conclusions: We proved that the Baveno classification is applicable in real life, and it is better at evaluating anxiety and depression using questionnaires and can identify new patients who need CPAP therapy, independently of other OSAS symptoms, primarily daytime sleepiness.
Collapse
Affiliation(s)
- Romana Suša
- Pulmonology Clinic, University Clinical Centre Kragujevac, 34000 Kragujevac, Serbia; (R.S.); (V.Ć.); (N.I.); (I.Č.)
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Miloš Ratinac
- Pulmonology Clinic, University Clinical Centre Kragujevac, 34000 Kragujevac, Serbia; (R.S.); (V.Ć.); (N.I.); (I.Č.)
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Vojislav Ćupurdija
- Pulmonology Clinic, University Clinical Centre Kragujevac, 34000 Kragujevac, Serbia; (R.S.); (V.Ć.); (N.I.); (I.Č.)
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Ljiljana Novković
- Pulmonology Clinic, University Clinical Centre Kragujevac, 34000 Kragujevac, Serbia; (R.S.); (V.Ć.); (N.I.); (I.Č.)
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Mirjana Milojević-Ilić
- Pulmonology Clinic, University Clinical Centre Kragujevac, 34000 Kragujevac, Serbia; (R.S.); (V.Ć.); (N.I.); (I.Č.)
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Marina Petrović
- Pulmonology Clinic, University Clinical Centre Kragujevac, 34000 Kragujevac, Serbia; (R.S.); (V.Ć.); (N.I.); (I.Č.)
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Nebojša Igrutinović
- Pulmonology Clinic, University Clinical Centre Kragujevac, 34000 Kragujevac, Serbia; (R.S.); (V.Ć.); (N.I.); (I.Č.)
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Marko Vuleta
- Department of Cardiology, Clinical Hospital Center Dr Dragisa Misovic, 11000 Beograd, Serbia
| | | | - Olivera Kostić
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Center for Harm Reduction of Biological and Chemical Hazards, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Ivan Čekerevac
- Pulmonology Clinic, University Clinical Centre Kragujevac, 34000 Kragujevac, Serbia; (R.S.); (V.Ć.); (N.I.); (I.Č.)
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Center for Harm Reduction of Biological and Chemical Hazards, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| |
Collapse
|
4
|
Ilic I, Babic G, Dimitrijevic A, Sipetic Grujicic S, Ilic M. Psychological Distress in Women With Abnormal Pap Smear Results Attending Cervical Cancer Screening. J Low Genit Tract Dis 2023; 27:343-350. [PMID: 37535069 DOI: 10.1097/lgt.0000000000000761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
OBJECTIVE Women often experience psychological distress upon receipt of an abnormal Pap test result. This study aimed to evaluate psychological distress and its correlates among women who received an abnormal Pap screening test result. MATERIAL AND METHODS A cross-sectional study was performed in a cohort of 172 consecutive women who had attended screening for cervical cancer and who received abnormal Pap smear results and underwent additional diagnostic procedures (colposcopy/biopsy/endocervical curettage). The participants filled out a questionnaire on sociodemographic variables and the Cervical Dysplasia Distress Questionnaire. Multivariate linear regression was used for the analysis of the data. For multiple comparisons, the Bonferroni correction was applied to adjust the level of significance. RESULTS In women who received an abnormal Pap smear result, the independent correlate of higher psychological distress (by Cervical Dysplasia Distress Questionnaire score) before diagnostic procedures was lower satisfaction with information/support received from other people ( p = .002). Correlates of psychological distress in women older than 40 years with abnormal Pap smear were anxiety ( p = .042) and worry about having cervical cancer, general health and having sex ( p = .044). CONCLUSIONS The authors' findings could enable control of factors predictive of psychological distress in women who received a positive Pap smear screening test before undergoing diagnostic procedures, primarily via active provision of targeted information.
Collapse
Affiliation(s)
- Irena Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Goran Babic
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Aleksandra Dimitrijevic
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | | | - Milena Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| |
Collapse
|
5
|
Zolfaghary F, MashaghiTabari R, Dezhman M, Bijani A, Kheirkha F, Adib-Rad H. Predictors of quality of life and mental health in breast cancer survivors in Northern Iran. BMC Womens Health 2023; 23:378. [PMID: 37464348 PMCID: PMC10354929 DOI: 10.1186/s12905-023-02533-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/08/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND AND PURPOSE The global incidence of breast cancer is the highest among all cancers and is the primary reason for cancer-related fatalities. Our study aimed to assess the predictors of quality of life (QOL) and mental health in breast cancer survivors in Northern Iran. METHODS This cross-sectional study was done on 96 female breast cancer survivors between the ages of 20 and 65 and was based on convenience samples. We gathered information through demographic and fertility data, a QOL survey, and the Hospital Anxiety and Depression Scale (HADS). A significance level of P < 0.05 was set for the analysis. RESULTS In this study, results showed that 11.5% of women had the optimal quality of life, 31.3% favorable quality of life, and 57.3% undesirable quality of life. The average HADS score was 20.14 ± 3.07, with anxiety scores of 10.21 ± 2.31 and depression scores of 9.93 ± 1.64. On multiple linear regression, marital relationship and the number of children were predictors of quality of life (β=-17.624, p = 0.023 and β=-7.427, p = 0.016, respectively), as well as the husband's education and having no history of other cancers in the woman, were the most important predictors of HADS (β = 0.763, p = 0.039 and β=-0.528, p = 0.016, respectively). CONCLUSION It is crucial to provide exceptional care to breast cancer patients during treatment and post-recovery. Emotional and psychological support is a fundamental requirement for their well-being.
Collapse
Affiliation(s)
- Fatemeh Zolfaghary
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Reza MashaghiTabari
- Faculty of Medicine, Belgrade University of Medical Sciences, Belgrade, Serbia
| | - Mobina Dezhman
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Farzan Kheirkha
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hajar Adib-Rad
- Infertility and Health Reproductive Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| |
Collapse
|
6
|
Vallone F, Galvin J, Cattaneo Della Volta MF, Akhtar A, Chua S, Ghio E, Giovazolias T, Kazakou Z, Kritikou M, Koutra K, Kovacevic S, Lee-Treweek G, Mašková I, Mavritsaki E, Nastic J, Plassova M, Stuchlíková I, Zurlo MC. Technostress and academic motivation: direct and indirect effects on university students' psychological health. Front Psychol 2023; 14:1211134. [PMID: 37457063 PMCID: PMC10348917 DOI: 10.3389/fpsyg.2023.1211134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 05/31/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Research has well demonstrated that the pandemic entailed several implications among university students worldwide in terms of increased use of Information and Communication Technologies (ICTs), technostress, disruptions in academic goals and motivation processes, and growing psychological suffering. Responding to the new research need to go in-depth into the processes linking technostress and motivation dimensions to inform current research/interventions, the present study aimed to explore the direct effects of perceived Technostress dimensions (Techno-Overload, Work-Home Conflict, Pace of Change, Techno-Ease, Techno-Reliability, and Techno-Sociality) and Academic Motivation dimensions (Amotivation, Intrinsic, and Extrinsic Motivation dimensions) on students' perceived levels of Anxiety/Depression and test the potential indirect effect (mediating role) of Academic Motivation dimensions in the associations between Technostress and psychological health conditions. Methods Overall, 1,541 students from five European countries (Czech Republic, Greece, Italy, Serbia, United Kingdom) completed a survey comprising a Background Information Form, the Technostress Scale, the Academic Motivation Scale-College, and the Hospital Anxiety and Depression Scale. Hayes' PROCESS tool was used to test direct and indirect (mediating) effects. Results Data revealed that Techno-Overload, Work-Home Conflict, Amotivation, and Extrinsic Motivation-Introjected had a direct negative effect, whereas Techno-Ease, Techno-Reliability, Techno-Sociality, all Intrinsic Motivation dimensions, and Extrinsic Motivation-Identified had a direct protective role for students' psychological health. The significant indirect role of motivation dimensions in the associations between Technostress dimensions and Anxiety/Depression was fully supported. Discussion Findings allow gaining further insight into the pathways of relationships between technostress, motivation, and psychological health, to be used in the current phase, featured by the complete restoration of face-to-face contacts, to inform the development of tailored research and interventions, which address lights and shadows of the technology use, and which take into account the necessity to enhance its potentials yet without impairing students' motivation and psychological health.
Collapse
Affiliation(s)
- Federica Vallone
- Dynamic Psychology Laboratory, Department of Political Sciences, University of Naples Federico II, Naples, Italy
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - John Galvin
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Maria Francesca Cattaneo Della Volta
- Dynamic Psychology Laboratory, Department of Political Sciences, University of Naples Federico II, Naples, Italy
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Athfah Akhtar
- Birmingham City University, Birmingham, United Kingdom
| | | | - Emilie Ghio
- Birmingham City University, Birmingham, United Kingdom
| | - Theodoros Giovazolias
- Department of Psychology, School of Social Sciences, University of Crete, Crete, Greece
| | - Zoe Kazakou
- Birmingham City University, Birmingham, United Kingdom
| | - Marina Kritikou
- Department of Psychology, School of Social Sciences, University of Crete, Crete, Greece
| | - Katerina Koutra
- Department of Psychology, School of Social Sciences, University of Crete, Crete, Greece
| | | | | | - Ivana Mašková
- Department of Psychology, Faculty of Education, University of South Bohemia, Ceské Budějovice, Czechia
| | | | | | - Michala Plassova
- Department of Psychology, Faculty of Education, University of South Bohemia, Ceské Budějovice, Czechia
| | - Iva Stuchlíková
- Department of Psychology, Faculty of Education, University of South Bohemia, Ceské Budějovice, Czechia
| | - Maria Clelia Zurlo
- Dynamic Psychology Laboratory, Department of Political Sciences, University of Naples Federico II, Naples, Italy
- Department of Humanities, University of Naples Federico II, Naples, Italy
| |
Collapse
|
7
|
Ilic I, Babic G, Dimitrijevic A, Sipetic Grujicic S, Ilic M. Predictors of depressive symptoms before and after diagnostic procedures in women with abnormal Pap smear attending cervical cancer screening programme in Serbia. Eur J Cancer Care (Engl) 2022; 31:e13634. [PMID: 35697508 DOI: 10.1111/ecc.13634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 04/07/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Receipt of a positive Papanicolaou screening result and subsequent referral for diagnostic tests can cause psychological stress. Still, not enough is known about depression before and after the diagnostic test in these women. The aim of this study was to determine the burden and predictors of depressive symptoms prior to and after diagnostic investigations in women who had received a positive Papanicolaou screening result. METHODS This was a cross-sectional study. Study cohort comprised women who received an abnormal Papanicolaou screening result. Women completed the socio-demographic questionnaire and 'The Center for Epidemiologic Studies Depression, CES-D' questionnaire before and after diagnostic tests (colposcopy/biopsy/endocervical curettage) to assess factors related to depression. RESULTS No significant difference was noted in the frequency of depressive symptoms (CES-D score ≥ 16) before and after diagnostic investigations, but the mean score on CES-D scale showed a significant difference before and after diagnostic investigations (13.98 ± 9.56 and 12.74 ± 9.15, respectively). A significant predictor of depression before diagnostic investigations was spontaneous abortion, whereas family history of other gynaecological cancers was a predictor of depression after diagnostic investigations. CONCLUSIONS Our findings could contribute to improving the rates of cervical cancer screening, by identifying women at risk for depression before and after investigations.
Collapse
Affiliation(s)
- Irena Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Goran Babic
- Department of Gynaecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Aleksandra Dimitrijevic
- Department of Gynaecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | | | - Milena Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| |
Collapse
|
8
|
Ilic I, Babic G, Dimitrijevic A, Grujicic SS, Ilic MD. Depression before and after diagnostic procedures among women with abnormal finding of Papanicolaou screening test. Cancer Med 2022; 11:3518-3528. [PMID: 35322940 PMCID: PMC9487877 DOI: 10.1002/cam4.4709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/16/2022] [Accepted: 03/13/2022] [Indexed: 11/08/2022] Open
Abstract
Background 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. Methods 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. Results 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). Conclusion 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.
Collapse
Affiliation(s)
- Irena Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Goran Babic
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Aleksandra Dimitrijevic
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | | | - Milena D Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| |
Collapse
|