Dataset Information

Depressive symptoms, neuroticism, and participation in breast and cervical cancer screening: Cross-sectional and prospective evidence from UK Biobank.

ABSTRACT:

Objective

To assess the cross-sectional and prospective associations between depressive symptoms, neuroticism, and participation in breast and cervical screening in the UK.

Methods

Women in the UK Biobank cohort with complete data who were eligible for breast cancer screening (aged 50-70 years, N = 143 461) and/or cervical screening (<65 years, N = 141 753) at baseline recruitment (2006-2010) and those with follow-up data (2014-2019) were identified (N = 11 050 and N = 9780 for breast and cervical screening). Depressive symptoms and neuroticism were self-reported at baseline (range 0-12 with higher scores reflecting greater severity). Primary outcomes were reporting being up to date with breast and cervical screening. For prospective analyses, patterns of screening participation from baseline to follow-up were identified. Logistic regression was used to analyse associations, adjusted for potential confounding factors.

Results

More severe depressive symptoms were associated with reduced likelihood of breast (OR = 0.960, 95% CI: 0.950,0.970) and cervical (OR = 0.958, 95% CI: 0.950,0.966) screening participation, in cross-sectional analyses. Higher neuroticism scores were associated with reduced cervical screening participation, but the opposite was found for breast cancer screening. Examination of individual neuroticism items revealed that anxiety and worry were associated with increased breast screening. At follow-up, higher baseline depressive symptoms were related to decreased cervical screening (OR = 0.955, 95% CI: 0.913,0.999), but not with breast screening.

Conclusions

More severe depressive symptoms may be a barrier for breast and cervical screening and could be an indicator for more proactive strategies to improve uptake.

SUBMITTER: Niedzwiedz CL

PROVIDER: S-EPMC7002161 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND.:Cognitive impairment associated with lifetime major depressive disorder (MDD) is well-supported by meta-analytic studies, but population-based estimates remain scarce. Previous UK Biobank studies have only shown limited evidence of cognitive differences related to probable MDD. Using updated cognitive and clinical assessments in UK Biobank, this study investigated population-level differences in cognitive functioning associated with lifetime MDD. METHODS.:Associations between lifetime MDD and cognition (performance on six tasks and general cognitive functioning [g-factor]) were investigated in UK Biobank (N-range 7,457-14,836, age 45-81 years, 52% female), adjusting for demographics, education, and lifestyle. Lifetime MDD classifications were based on the Composite International Diagnostic Interview. Within the lifetime MDD group, we additionally investigated relationships between cognition and (a) recurrence, (b) current symptoms, (c) severity of psychosocial impairment (while symptomatic), and (d) concurrent psychotropic medication use. RESULTS.:Lifetime MDD was robustly associated with a lower g-factor (? = -0.10, PFDR = 4.7 × 10-5), with impairments in attention, processing speed, and executive functioning (? ? 0.06). Clinical characteristics revealed differential profiles of cognitive impairment among case individuals; those who reported severe psychosocial impairment and use of psychotropic medication performed worse on cognitive tests. Severe psychosocial impairment and reasoning showed the strongest association (? = -0.18, PFDR = 7.5 × 10-5). CONCLUSIONS.:Findings describe small but robust associations between lifetime MDD and lower cognitive performance within a population-based sample. Overall effects were of modest effect size, suggesting limited clinical relevance. However, deficits within specific cognitive domains were more pronounced in relation to clinical characteristics, particularly severe psychosocial impairment.