Schmitz Norbert, Kruse Johannes, Kugler Joachim
Clinic for Psychosomatic Medicine and Psychotherapy, Heinrich-Heine-University, Bergisch Landstrasse 2, H19, D-40605 Duesseldorf, Germany.
Am J Psychiatry. 2003 Sep;160(9):1670-6. doi: 10.1176/appi.ajp.160.9.1670.
Epidemiological studies have reported an association between smoking and mental disorders. However, little is known about the impairment associated with nicotine dependence.
The authors assessed health-related quality of life, disability, and psychiatric comorbidity in adults with and without nicotine dependence. The analysis was based on data from 3,293 respondents, ages 18 to 65, from the German National Health Interview and Examination Survey, a nationally representative multistage probability survey conducted from 1997 to 1999. The authors assessed rates of smoking and health-related quality of life (Medical Outcomes Study 36-item Short-Form Health Survey) by questionnaires. Nicotine dependence and other mental disorders were assessed with a modified version of the Composite International Diagnostic Interview.
The population prevalence of current smoking was 36.2% and the 1-year prevalence of nicotine dependence was 9.4%. Nicotine-dependent smokers reported a poorer quality of life than the subjects without nicotine dependence. These relationships were stable after adjustment for sociodemographic characteristics. More than half of the subjects with nicotine dependence fulfilled criteria for at least one other mental disorder. Subjects suffering from nicotine dependence reported greater disability in the last month and in the last year.
Smokers with nicotine dependence should be distinguished from other smokers in evaluations of the health status of populations.
流行病学研究报告了吸烟与精神障碍之间的关联。然而，对于与尼古丁依赖相关的损害却知之甚少。
作者评估了有和没有尼古丁依赖的成年人的健康相关生活质量、残疾情况和精神疾病共病情况。该分析基于来自德国国民健康访谈与检查调查的3293名年龄在18至65岁之间的受访者的数据，这是一项于1997年至1999年进行的具有全国代表性的多阶段概率调查。作者通过问卷调查评估吸烟率和健康相关生活质量（医学结局研究36项简短健康调查）。使用综合国际诊断访谈的修改版评估尼古丁依赖和其他精神障碍。
当前吸烟的人群患病率为36.2%，尼古丁依赖的1年患病率为9.4%。尼古丁依赖吸烟者报告的生活质量比没有尼古丁依赖的受试者差。在对社会人口学特征进行调整后，这些关系依然稳定。超过一半的尼古丁依赖受试者符合至少一种其他精神障碍的标准。患有尼古丁依赖的受试者报告在过去一个月和过去一年中的残疾程度更高。
在评估人群健康状况时，应将尼古丁依赖吸烟者与其他吸烟者区分开来。
