INSERM, Unit 894, Centre Psychiatrie et Neurosciences, Faculté de Médecine, Université Paris Descartes, 2 ter, rue d'Alésia 75014 Paris, France.
Alcohol Alcohol. 2010 Mar-Apr;45(2):167-72. doi: 10.1093/alcalc/agp094. Epub 2010 Jan 20.
To examine the pattern of psychiatric comorbidity associated with nicotine dependence among alcohol-dependent respondents in the general population.
Drawn from a US national survey of 43,000 adults The (National Epidemiologic Survey on Alcohol and Related Conditions) who took part in a face-to-face interview, data were examined on the 4782 subjects with lifetime alcohol dependence, and comparisons were made between those with and those without nicotine dependence.
Nicotine dependence was reported by 48% of the alcohol-dependent respondents. They reported higher lifetime rates of panic disorder, specific and social phobia, generalized anxiety disorder, major depressive episode, manic disorder, suicide attempt, antisocial personality disorder and all addictive disorders than those without nicotine dependence. After controlling for the effects of any psychiatric and addictive disorder, alcohol-dependent subjects with nicotine dependence were more than twice as likely as non-nicotine-dependent, alcohol-dependent subjects to have at least one other lifetime addiction diagnosis (adjusted odds ratio 2.36; 95% confidence interval 2.07-2.68).
Nicotine dependence represents a general marker of psychiatric comorbidity, particularly of addictive comorbidity. It may be used as a screening measure for psychiatric diagnoses in clinical practice as well as in future trials.
探讨一般人群中酒精依赖者与尼古丁依赖相关的精神共病模式。
该研究的数据来自于一项针对 43000 名美国成年人的全国性调查（国家酒精与相关情况流行病学调查），这些成年人接受了面对面的访谈。研究人员对 4782 名有终身酒精依赖的受试者进行了数据分析，并对有和没有尼古丁依赖的受试者进行了比较。
48%的酒精依赖受访者报告有尼古丁依赖。与没有尼古丁依赖的人相比，他们报告的终生惊恐障碍、特定恐惧症和社交恐惧症、广泛性焦虑障碍、重性抑郁发作、躁狂障碍、自杀未遂、反社会人格障碍和所有成瘾障碍的发生率更高。在控制任何精神和成瘾障碍的影响后，有尼古丁依赖的酒精依赖受试者比没有尼古丁依赖的酒精依赖受试者更有可能被诊断出至少有一种其他的终生成瘾障碍（调整后的优势比 2.36；95%置信区间 2.07-2.68）。
尼古丁依赖代表了精神共病的一般标志，特别是成瘾共病的标志。它可以作为临床实践和未来试验中精神诊断的筛查指标。
