Department of Psychiatry, Stanford University, Stanford, CA, USA.
Neuropsychiatr Dis Treat. 2007 Aug;3(4):487-93.
Depression and smoking are highly comorbid. The vast majority of psychiatrists treating depressed patients do not target or treat nicotine dependence, and many inpatient psychiatric facilities implicitly condone smoking by providing 'smoke breaks'. The reasons for failure to treat are unclear, but are probably linked to the notion that depressed smokers are neither willing nor able to quit, and will become more depressed if they try. We review the clinical evidence on depression and smoking cessation, and find little support for current psychiatric practice. Although quitting smoking does appear to pose a risk for the development of depression, this risk is not clearly higher in those with a past history of depression than those without. Depressed smokers are as capable as nondepressed smokers of quitting smoking, and at least one-quarter of depressed smokers is willing to try. Sustained abstinence may even lead to improvement in depressive disorders. More research is needed to understand the relationship between depression and quitting smoking, but current clinical evidence suggests more resiliency among depressed smokers than common clinical wisdom would dictate.
抑郁和吸烟高度共病。绝大多数治疗抑郁症患者的精神科医生没有针对或治疗尼古丁依赖，许多住院精神科病房通过提供“吸烟休息时间”来默认纵容吸烟。未能治疗的原因尚不清楚，但可能与以下观念有关：即抑郁吸烟者既不愿意也无法戒烟，如果尝试戒烟，他们会变得更加抑郁。我们回顾了关于抑郁和戒烟的临床证据，发现目前的精神科实践几乎没有得到支持。虽然戒烟似乎确实会增加抑郁的风险，但这种风险在有过去抑郁史的人群中并不比没有抑郁史的人群更高。抑郁吸烟者和非抑郁吸烟者一样有能力戒烟，至少有四分之一的抑郁吸烟者愿意尝试。持续戒断甚至可能导致抑郁障碍的改善。需要更多的研究来了解抑郁和戒烟之间的关系，但目前的临床证据表明，抑郁吸烟者比常见的临床观点所表明的更有弹性。
