Effect of stress and depression on the frequency of squamous intraepithelial lesions

L. Stewart Massad, Denis Agniel, Howard Minkoff, D. Heather Watts, Gypsyamber D'Souza, Alexandra M. Levine, Teresa M. Darragh, Mary Young, Anthony Cajigas, Kathleen Weber

Research output: Contribution to journalArticle

Abstract

Objective: To explore the previously reported associations between cervical squamous lesions and psychologic measures of stress and depression. Methods: 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. Results: 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. Conclusions: We found no evidence that stress and depression affect the prevalence of cervical squamous lesions.

Original languageEnglish (US)
Pages (from-to)42-47
Number of pages6
JournalJournal of Lower Genital Tract Disease
Volume15
Issue number1
DOIs
StatePublished - Jan 2011

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Depression
Post-Traumatic Stress Disorders
Confidence Intervals
Checklist
Epidemiologic Studies
Odds Ratio
HIV
Squamous Intraepithelial Lesions of the Cervix
Papanicolaou Test
Sexual Partners
Psychological Stress
Self Report
Multicenter Studies
Cohort Studies

Keywords

  • cervical lesion
  • depression
  • Pap test
  • Stress

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Effect of stress and depression on the frequency of squamous intraepithelial lesions. / Massad, L. Stewart; Agniel, Denis; Minkoff, Howard; Watts, D. Heather; D'Souza, Gypsyamber; Levine, Alexandra M.; Darragh, Teresa M.; Young, Mary; Cajigas, Anthony; Weber, Kathleen.

In: Journal of Lower Genital Tract Disease, Vol. 15, No. 1, 01.2011, p. 42-47.

Research output: Contribution to journalArticle

Massad, LS, Agniel, D, Minkoff, H, Watts, DH, D'Souza, G, Levine, AM, Darragh, TM, Young, M, Cajigas, A & Weber, K 2011, 'Effect of stress and depression on the frequency of squamous intraepithelial lesions', Journal of Lower Genital Tract Disease, vol. 15, no. 1, pp. 42-47. https://doi.org/10.1097/LGT.0b013e3181e66a82
Massad, L. Stewart ; Agniel, Denis ; Minkoff, Howard ; Watts, D. Heather ; D'Souza, Gypsyamber ; Levine, Alexandra M. ; Darragh, Teresa M. ; Young, Mary ; Cajigas, Anthony ; Weber, Kathleen. / Effect of stress and depression on the frequency of squamous intraepithelial lesions. In: Journal of Lower Genital Tract Disease. 2011 ; Vol. 15, No. 1. pp. 42-47.
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abstract = "Objective: To explore the previously reported associations between cervical squamous lesions and psychologic measures of stress and depression. Methods: 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. Results: 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. Conclusions: We found no evidence that stress and depression affect the prevalence of cervical squamous lesions.",
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AU - Agniel, Denis

AU - Minkoff, Howard

AU - Watts, D. Heather

AU - D'Souza, Gypsyamber

AU - Levine, Alexandra M.

AU - Darragh, Teresa M.

AU - Young, Mary

AU - Cajigas, Anthony

AU - Weber, Kathleen

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N2 - Objective: To explore the previously reported associations between cervical squamous lesions and psychologic measures of stress and depression. Methods: 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. Results: 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. Conclusions: We found no evidence that stress and depression affect the prevalence of cervical squamous lesions.

AB - Objective: To explore the previously reported associations between cervical squamous lesions and psychologic measures of stress and depression. Methods: 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. Results: 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. Conclusions: We found no evidence that stress and depression affect the prevalence of cervical squamous lesions.

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