Prevalence and Correlates of Depression and Anxiety Among Women with HPV-Related Cervical Disease: A Hospital-Based Cross-Sectional Study in Shenzhen, China
Bibliographic record
Abstract
Shu Jing,1 You Xin,1 Zhenwei Dai,2 Yanzhu Wang,3 Tianjie Yang,3 Qiufen Lin,3 Ting Shan,3 Leilei Zhu,3 Haiyan Hu,3 Xiaoyou Su1,4 1School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China; 2Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, People’s Republic of China; 3Gynecology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, 518028, People’s Republic of China; 4State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, Peoples Republic of China’Correspondence: Xiaoyou Su, Email suxiaoyou@pumc.edu.cn Haiyan Hu, Email 2419959031@qq.comBackground: Human papillomavirus (HPV) infection is a prevalent sexually transmitted infection, significantly contributing to cervical lesions and cancer. It not only damages physical health but also causes substantial mental problems, including depression and anxiety. However, research remains fragmented in China.Methods: A hospital-based cross-sectional study was conducted in Shenzhen, China, from December 2024 to February 2025. Five hundred and one female participants with HPV infection, cervical lesions, or cancers were recruited via convenience sampling. Data on demographic characteristics, HPV-related information, and psychosocial indicators were collected using a self-reported questionnaire. Key measures included the 9-item Patient Health Questionnaire (PHQ-9, cutoff ≥ 10 for PHQ-defined depression), 7-item Generalized Anxiety Disorder Scale (GAD-7, cutoff ≥ 10 for GAD-defined anxiety), 14-item Fatigue Scale (FS-14, higher scores = more severe fatigue), 10-item Connor-Davidson Resilience Scale (CD-RISC-10, higher scores = stronger resilience), and 5-item Mindful Attention Awareness Scale (MAAS-5, higher scores = lower mindfulness levels). Univariate analysis and multivariable binary logistic regression were performed to identify factors associated with depression and anxiety.Results: The prevalence of PHQ-defined depression and GAD-defined anxiety was 22.36% (n=112/501, 95% CI: 0.187– 0.260) and 21.36% (n=107/501, 95% CI: 0.178– 0.250), respectively. Multivariable binary logistic regression indicated that high-grade cervical lesions or cervical cancer (vs HPV infection or low-grade cervical lesions; Depression: OR = 8.879, P < 0.00; Anxiety: OR = 14.154, P < 0.001) and poor sleep condition (Depression: OR = 1.155, P = 0.004; Anxiety: OR = 1.175, P < 0.001) emerged as significant predictors of depression and anxiety, whereas higher levels of resilience (Depression: OR = 0.896, P = 0.001; Anxiety: OR = 0.934, P = 0.018) demonstrated a protective effect among females infected with HPV. Meanwhile, the results also found that fatigue (OR = 1.284, P = 0.008) and lower mindfulness level (OR = 1.163, P = 0.011) were also associated with depression among females infected with HPV.Conclusion: This study reveals a high prevalence of depression and anxiety among HPV-infected women, along with the associations between PHQ-defined depression, GAD-defined anxiety, and advanced disease staging, fatigue, lower mindfulness, and higher resilience in women infected with HPV. Routine mental health assessment is warranted for this population, especially for those with high-grade cervical lesions or cervical cancer.Keywords: HPV-infected women, depression, anxiety, influencing factors
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".