Leventhal Adam M, Kahler Christopher W, Ray Lara A, Zimmerman Mark
Center for Alcohol and Addiction Studies, Brown Medical School, Brown University, Providence, RI 02912, USA.
Addict Behav. 2009 Mar;34(3):297-303. doi: 10.1016/j.addbeh.2008.11.008. Epub 2008 Nov 21.
The aim of this study was to elucidate the depression-nicotine dependence link by evaluating which specific depressive symptoms are uniquely associated with nicotine dependence in psychiatric outpatients. Participants were assessed using structured clinical interviews which yielded psychiatric diagnoses and clinical ratings on a wide variety of depressive symptoms. Depressive symptoms were compared across three groups: (1) patients with no history of nicotine dependence (NND; n=1015); (2) patients with past nicotine dependence in full remission for at least 2 months (PND; n=211); and (3) patients with current nicotine dependence (CND; n=342). Participants with CND evidenced elevations on certain typical-vegetative, melancholic, and dysphoric depressive symptoms as compared to patients with NND and (to a lesser extent) patients with PND. Group differences were most consistent for depressed mood, anhedonia, appetite/weight loss, psychomotor disturbance, fatigue, and insomnia. Differences were least apparent for atypical symptoms. The symptomatic profiles of PND and NND patients were virtually indistinguishable. Certain vegetative, melancholic and dysphoric depressive symptoms are closely associated with nicotine dependence and could play an important etiological role in depression-nicotine dependence comorbidity.
本研究的目的是通过评估哪些特定的抑郁症状与精神科门诊患者的尼古丁依赖有独特关联，来阐明抑郁与尼古丁依赖之间的联系。使用结构化临床访谈对参与者进行评估，该访谈得出了精神科诊断以及关于多种抑郁症状的临床评分。在三组之间比较抑郁症状：（1）无尼古丁依赖史的患者（NND；n = 1015）；（2）过去有尼古丁依赖且完全缓解至少2个月的患者（PND；n = 211）；以及（3）当前有尼古丁依赖的患者（CND；n = 342）。与NND患者以及（在较小程度上）PND患者相比，CND患者在某些典型的植物神经、抑郁性和烦躁性抑郁症状方面有所升高。在情绪低落、快感缺失、食欲/体重减轻、精神运动障碍、疲劳和失眠方面，组间差异最为一致。非典型症状的差异最不明显。PND和NND患者的症状特征几乎无法区分。某些植物神经、抑郁性和烦躁性抑郁症状与尼古丁依赖密切相关，并且可能在抑郁与尼古丁依赖共病中起重要的病因学作用。
