title: Psychosocial factors and the course of cervical intra-epithelial neoplasia: a prospective study.
abstract: OBJECTIVE
  To investigate the influence of psychosocial factors on the course of cervical intra-epithelial neoplasia (CIN).
  
  
  METHODS
  A group of 93 patients with CIN 1 or 2 was followed for 2.25 years by half-yearly colposcopy and cytology. Negatively-rated life events, social support, and coping style were studied in relation to distress during follow-up and in relation to time till progression and regression of CIN. Human papillomavirus (HPV) infection was controlled for as well as sick role bias caused by suspicion of having cervical cancer and distress due to the abnormal cervical smear.
  
  
  RESULTS
  During follow-up, progression was found in 20 patients (22%), stable disease in 22 patients (24%), and regression in 51 patients (55%). Negatively-rated life events and lack of social support predicted distress longitudinally. No association was found between progression or regression of CIN and negatively-rated life events, lack of social support, coping style, and distress.
  
  
  CONCLUSIONS
  We found no evidence that psychosocial factors influence the course of CIN.
authors.affiliation: Helen Dowling Institute, Center for Psycho-oncology, Utrecht, The Netherlands. esmtiersma@yahoo.com
authors.forename: E S M
authors.initials: ES
authors.lastname: Tiersma
authors.forename: M L
authors.initials: ML
authors.lastname: van der Lee
authors.forename: B
authors.initials: B
authors.lastname: Garssen
authors.forename: A A W
authors.initials: AA
authors.lastname: Peters
authors.forename: A P
authors.initials: AP
authors.lastname: Visser
authors.forename: G J
authors.initials: GJ
authors.lastname: Fleuren
authors.forename: K M
authors.initials: KM
authors.lastname: van Leeuwen
authors.forename: S
authors.initials: S
authors.lastname: le Cessie
authors.forename: K
authors.initials: K
authors.lastname: Goodkin
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008960:Models, Psychological; D011446:Prospective Studies; D011584:Psychology; D012044:Regression Analysis; D012944:Social Support; D013312:Stress, Physiological / Q000209:etiology / Q000523:psychology; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000523:psychology*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000523:psychology*