Kodl Molly M, Fu Steven S, Willenbring Mark L, Gravely Amy, Nelson David B, Joseph Anne Marie
Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, Minnesota 55417, USA.
Alcohol Clin Exp Res. 2008 Jan;32(1):92-9. doi: 10.1111/j.1530-0277.2007.00556.x. Epub 2007 Dec 12.
Although depression is common among alcohol and tobacco dependent patients, its impact on treatment outcomes is not well established. The purpose of this study was to examine the impact of depressive symptoms on abstinence from tobacco and alcohol after treatment for alcohol dependence and nicotine dependence.
The Timing of Alcohol and Smoking Cessation Study (TASC) randomized adults receiving intensive alcohol dependence treatment, who were also smokers, to concurrent or delayed smoking cessation treatment. The sample consisted of 462 adults who completed depression and substance use (alcohol and smoking) assessments at treatment entry and 6, 12, and 18 months posttreatment. Longitudinal regression models were used to examine the relationships between depression and subsequent abstinence from alcohol and tobacco after baseline characteristics, including alcohol and smoking histories, were considered.
Depressive symptoms were prospectively related to nonabstinence from alcohol. Depressive symptoms at the previous assessment increased the odds of drinking at the subsequent time point by a factor of 1.67 (95% CI 1.14, 2.43), p < 0.01. Depressive symptoms were not significantly related to subsequent abstinence from cigarettes.
Depression is an important negative predictor of the ability to maintain abstinence from alcohol within the context of intensive alcoholism and smoking treatment. It may be important to include depression-specific interventions for alcohol and tobacco dependent individuals to facilitate successful drinking treatment outcomes.
尽管抑郁症在酒精和烟草依赖患者中很常见,但其对治疗结果的影响尚未明确。本研究的目的是探讨抑郁症状对酒精依赖和尼古丁依赖治疗后戒烟和戒酒的影响。
酒精和吸烟戒断时机研究(TASC)将接受强化酒精依赖治疗且同时吸烟的成年人随机分为同时进行或延迟进行戒烟治疗两组。样本包括462名成年人,他们在治疗开始时以及治疗后6个月、12个月和18个月完成了抑郁和物质使用(酒精和吸烟)评估。在考虑了包括饮酒和吸烟史在内的基线特征后,使用纵向回归模型来检验抑郁与随后戒酒和戒烟之间的关系。
抑郁症状与戒酒失败呈前瞻性相关。前一次评估时的抑郁症状使后续时间点饮酒的几率增加了1.67倍(95%置信区间1.14,2.43),p<0.01。抑郁症状与随后戒烟无显著相关性。
在强化酒精成瘾和吸烟治疗的背景下,抑郁症是维持戒酒能力的一个重要负面预测因素。对酒精和烟草依赖个体采用特定的抑郁干预措施,可能对促进成功戒酒治疗结果很重要。