Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA.
Drug Alcohol Depend. 2010 Apr 1;108(1-2):7-12. doi: 10.1016/j.drugalcdep.2009.11.004. Epub 2009 Dec 16.
The current study examined tobacco withdrawal symptoms and withdrawal-related discomfort and relapse in smokers with and without current mood disorders, anxiety disorders, alcohol use disorders (AUD), and substance use disorders (SUD).
The subsample of current daily smokers (n=8213) from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, Wave 1, 2001-2002, full sample n=43,093) were included in these analyses. Cross-sectional data compared smokers with and without current psychiatric disorders on withdrawal symptoms using logistic regression models. The effects of having a co-morbid psychiatric disorder and AUD/SUD compared to a psychiatric disorder alone on nicotine withdrawal were also examined.
Participants with a current mood disorder, anxiety disorder, AUD, or SUD were more likely to report withdrawal symptoms and reported more withdrawal symptoms than those without current disorders. Having a current mood disorder, anxiety disorder, or SUD was also associated with increased likelihood of withdrawal-related discomfort and relapse. There were no significant interactions between psychiatric disorders and AUDs/SUDs on withdrawal symptoms or behavior.
Participants with a current Axis I disorder were more likely to experience tobacco withdrawal symptoms and withdrawal-related discomfort and relapse. Having a co-morbid psychiatric disorder and AUD/SUD did not synergistically increase the experience of withdrawal-related symptoms or relapse. It is important to identify Axis I disorders in smokers and provide these smokers with more intensive and/or longer treatments to help them cope with withdrawal symptoms and prevent relapse.
本研究考察了有和没有当前心境障碍、焦虑障碍、酒精使用障碍（AUD）和物质使用障碍（SUD）的吸烟者的烟草戒断症状和戒断相关不适以及复吸情况。
这些分析纳入了来自国家酒精流行病学调查和相关条件（NESARC，波 1，2001-2002 年，总样本量 n=43093）的当前每日吸烟者的亚样本（n=8213）。使用逻辑回归模型比较了有和没有当前精神障碍的吸烟者的戒断症状。还检查了同时患有共病精神障碍和 AUD/SUD 与仅患有精神障碍对尼古丁戒断的影响。
患有当前心境障碍、焦虑障碍、AUD 或 SUD 的参与者更有可能报告戒断症状，并且比没有当前障碍的参与者报告更多的戒断症状。患有当前心境障碍、焦虑障碍或 SUD 也与戒断相关不适和复吸的可能性增加有关。在戒断症状或行为方面，精神障碍和 AUD/SUD 之间没有显著的相互作用。
当前存在 Axis I 障碍的参与者更有可能经历烟草戒断症状和戒断相关不适和复吸。同时患有共病精神障碍和 AUD/SUD 并没有协同增加戒断相关症状或复吸的体验。在吸烟者中识别出 Axis I 障碍，并为这些吸烟者提供更密集和/或更长时间的治疗，以帮助他们应对戒断症状并预防复吸，这一点非常重要。
