Tsoh J Y, Humfleet G L, Muñoz R F, Reus V I, Hartz D T, Hall S M
Department of Psychiatry, University of California, San Francisco 94143, USA.
Am J Psychiatry. 2000 Mar;157(3):368-74. doi: 10.1176/appi.ajp.157.3.368.
Case studies suggest cigarette abstinence may precipitate a major depressive episode. This study examined the incidence and predictors of major depression in the 12 months after treatment for smoking cessation.
Participants (N=304, 172 women) were recruited from two trials of smoking cessation. Both trials provided psychological group intervention, but one group received treatment with nicotine gum and the other was given nortriptyline or placebo. The incidence of major depressive episodes was identified by the Inventory to Diagnose Depression, which was administered at follow-up assessments.
The 12-month incidence of major depression after treatment for smoking cessation was 14.1% (N=43). Multiple logistic regression analyses indicated that history of depression, baseline Beck Depression Inventory score, college education, and age at smoking initiation were significant predictors of major depression after treatment. Abstinence at the end of treatment did not significantly predict major depression.
Patients who achieved abstinence from smoking showed a risk of developing depressive episodes similar to those who failed to achieve abstinence. As expected, patients who had a history of depression were more likely to experience depressive episodes after treatment for smoking cessation. The 12-month incidence of major depression in this study group was higher than that observed in the general population, but reasons for the elevation were not clear.
案例研究表明戒烟可能会引发重度抑郁发作。本研究调查了戒烟治疗后12个月内重度抑郁的发生率及预测因素。
参与者(N = 304,172名女性)来自两项戒烟试验。两项试验均提供心理团体干预,但一组接受尼古丁口香糖治疗,另一组给予去甲替林或安慰剂。通过在随访评估时使用的抑郁诊断量表来确定重度抑郁发作的发生率。
戒烟治疗后12个月内重度抑郁的发生率为14.1%(N = 43)。多项逻辑回归分析表明,抑郁病史、基线贝克抑郁量表得分、大学学历以及开始吸烟的年龄是治疗后重度抑郁的显著预测因素。治疗结束时的戒烟情况并不能显著预测重度抑郁。
成功戒烟的患者出现抑郁发作的风险与未成功戒烟的患者相似。正如预期的那样,有抑郁病史的患者在戒烟治疗后更有可能经历抑郁发作。该研究组中重度抑郁的12个月发生率高于一般人群,但升高的原因尚不清楚。