Klungsøyr Ole, Nygård Jan F, Sørensen Tom, Sandanger Inger
Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
Am J Epidemiol. 2006 Mar 1;163(5):421-32. doi: 10.1093/aje/kwj058. Epub 2006 Jan 4.
Smoking has been found to be associated with depression. Biologic hypotheses support causation in both directions. This study examined the association between cigarette smoking and a subsequent first depression. In 1990, 2,014 adults in Norway were interviewed about their lifestyle and mental health. A 2001 reinterview by trained interviewers defined the study cohort of 1,190 participants. The cases were those who experienced a first depression whose onset was estimated to occur during the follow-up period, based on retrospective assessment by the Composite International Diagnostic Interview (International Classification of Diseases, Tenth Revision). Cox regression was used to estimate the hazard rate of depression during follow-up. Alternative explanations for a direct causal influence from smoking on subsequent depression were assessed, and a sensitivity analysis was performed. The risk of depression was four times as high for heavy smokers compared with never smokers. A dose-response relation with an increasing hazard for past smokers and for an increasing number of cigarettes smoked per day for current smokers was found. Similarly, increasing smoking time was associated with increasing risk. Failure of other plausible alternatives to explain the observed association between smoking and depression might reflect a direct causal influence of smoking on depression.
研究发现吸烟与抑郁症有关。生物学假说支持双向因果关系。本研究调查了吸烟与随后首次患抑郁症之间的关联。1990年，对挪威的2014名成年人进行了关于其生活方式和心理健康的访谈。2001年，经过培训的访谈员再次进行访谈，确定了1190名参与者的研究队列。病例是那些经历首次抑郁症发作的人，根据综合国际诊断访谈（《国际疾病分类》第十版）的回顾性评估，其发病时间估计发生在随访期间。采用Cox回归估计随访期间抑郁症的风险率。评估了吸烟对随后抑郁症产生直接因果影响的其他解释，并进行了敏感性分析。与从不吸烟者相比，重度吸烟者患抑郁症的风险高出四倍。发现过去吸烟者以及当前吸烟者每天吸烟数量增加与风险增加存在剂量反应关系。同样，吸烟时间增加也与风险增加有关。其他合理的替代因素无法解释观察到的吸烟与抑郁症之间的关联，这可能反映了吸烟对抑郁症有直接因果影响。
