Despite reported increases in anxiety following a false-positive mammogram, there is little evidence the effect rises to the clinical level of initiating medication.
To analyze the effect of a false-positive mammogram on antidepressant or anxiolytic initiation and identify subpopulations most at risk.
MarketScan commercial and Medicaid claims databases used to identify women ages 40–64 undergoing screening mammography with no prior antidepressant or anxiolytic claims.
Using a retrospective cohort design, we estimated the effects of a false-positive relative to a negative mammogram on the likelihood of initiating antidepressants or anxiolytics using multivariate logistic models estimated separately by insurance type.
At 3 months after a false-positive mammogram, the relative risk (RR) for antidepressant or anxiolytic initiation was 1.19 [95% confidence interval (CI), 1.06–1.31] for the commercially insured and 1.13 (95% CI, 0.96–1.29) in the Medicaid population. In addition, 4 subgroups were at particularly elevated risk: commercially insured women ages 40–49 (RR=1.33; 95% CI, 1.13–1.54) or whose false-positive required multiple tests to resolve (RR=1.37; 95% CI, 1.17–1.57), included a biopsy (RR=1.68; 95% CI, 1.18–2.17), or whose resolution took >1 week (RR=1.21; 95% CI, 1.07–1.34).
False-positive mammograms were associated with significant increases in antidepressant or anxiolytic imitation among the commercially insured. Follow-up resources may be particularly beneficial for cases taking longer to resolve and involving biopsies or multiple tests. The results highlight the need to resolve false-positives quickly and effectively and to monitor depressive symptoms following a positive result.