Anxiety, depression, and influencing factors of STD clinic clients in Shanghai: a cross-sectional study

Background: Sexually transmitted diseases (STDs) not only cause physical discomfort but also lead to significant psychological burdens, contributing to anxiety and depression among affected individuals. Understanding these psychological impacts is essential for effective STD management and prevention. Methods: This cross-sectional study surveyed 3,360 patients attending STD clinics at 10 randomly selected public medical institutions in Shanghai from September 2020 to December 2021. A structured questionnaire was used, covering demographics, sexual behavior, STD knowledge, and validated anxiety and depression scales (GAD-7 and PHQ-9). Multivariate logistic regression was employed to identify factors associated with anxiety and depression symptoms. Results: Anxiety and depression symptoms were reported by 10.8 and 13.9% of participants, respectively. Univariate analysis revealed higher prevalence among women, younger individuals, singles, those with poor STD knowledge, and individuals without local residency. Logistic regression identified age, marital status, local residence duration, registered residence, and STD knowledge as significant factors influencing anxiety, while gender, marital status, education, local residence duration, registered residence, and STD knowledge were key factors affecting depression. All ORs were reported with 95% confidence intervals. Conclusion: Addressing psychological health is crucial in STD management. This study identifies registered residence status, short-term urban residency, and the paradoxical association between higher education and increased depression risk as noteworthy findings in the Chinese urban context. Targeted interventions based on the identified risk factors may contribute to improved treatment compliance, potentially reduce incidence rates, and could be associated with enhanced patient outcomes and public health.