Department of Psychiatry and Mental Health, Universidade Federal Fluminense, Niteroi, Brazil.
School of Psychological Sciences, Monash University, Melbourne, VIC, Australia.
J Dual Diagn. 2020 Oct;16(4):392-401. doi: 10.1080/15504263.2020.1786615. Epub 2020 Jul 9.
The objective of the study was to investigate whether a diagnosis of posttraumatic stress disorder (PTSD; full or partial) or specific PTSD symptom clusters predicted failure in quitting smoking in a trauma-exposed population. Participants were 310 smokers who attempted quitting smoking, either successfully (quitters, = 213) or not (relapsers, = 97), who lived in slums and were attending a family doctor program. Measurements included a general questionnaire covering sociodemographic characteristics, clinical status and life habits, and the Posttraumatic Stress Disorder Checklist - Civilian Version. Differences in sociodemographic, clinical and lifestyle characteristics between quitters and relapsers were compared using a chi-square test. Because of the small sample size, full and partial PTSD were collapsed into a single category. Significant differences ( ≤ .15) between quitters and relapsers were found in age, body mass index (BMI), income, alcohol consumption, and in the presence of full/partial PTSD diagnosis and of all three symptom clusters separately. Four logistic regression models predicting smoking cessation were modeled to control for confounding factors and included as independent variables a full/partial PTSD diagnosis and the three posttraumatic symptom clusters. The avoidance/numbing cluster presented the strongest association with relapse status (a 2.04, 95% CI [1.15, 3.63], = .015), followed by the full/partial PTSD (a 1.80, 95% CI [1.04, 3.14], = .038). The re-experiencing and the hyperarousal clusters were non-significantly associated with smoking cessation (a 1.34, 95% CI [0.80, 2.31], and a 1.65, 95% CI [0.96, 2.84], , respectively). Full/partial PTSD and posttraumatic symptom clusters uniquely predict risk for smoking relapse and thus may be a useful therapeutic target in trauma-exposed smokers.
这项研究的目的是调查创伤后应激障碍（PTSD；完全或部分）或特定 PTSD 症状群诊断是否能预测暴露于创伤人群中戒烟失败。参与者为 310 名尝试戒烟的吸烟者，其中 213 名成功（戒烟者），97 名失败（复吸者），他们居住在贫民窟，正在参加家庭医生计划。测量包括一个涵盖社会人口统计学特征、临床状况和生活习惯的一般问卷，以及创伤后应激障碍检查表-平民版。使用卡方检验比较戒烟者和复吸者在社会人口统计学、临床和生活方式特征上的差异。由于样本量小，将完全和部分 PTSD 合并为一个单一类别。在年龄、体重指数（BMI）、收入、饮酒量以及完全/部分 PTSD 诊断以及所有三个症状群的存在方面，戒烟者和复吸者之间存在显著差异（ ≤ .15）。为了控制混杂因素，建立了四个预测戒烟的逻辑回归模型，将完全/部分 PTSD 诊断和三个创伤后症状群作为自变量。回避/麻木症状群与复发状态的相关性最强（优势比[OR] 2.04，95%置信区间[CI] [1.15，3.63]， = .015），其次是完全/部分 PTSD（OR 1.80，95% CI [1.04，3.14]， = .038）。再体验和过度警觉症状群与戒烟无显著相关性（OR 1.34，95% CI [0.80，2.31]，和 OR 1.65，95% CI [0.96，2.84]， ）。完全/部分 PTSD 和创伤后症状群可独立预测吸烟复发的风险，因此可能是暴露于创伤的吸烟者的一个有用的治疗靶点。
