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