Breslau N
Department of Psychiatry, Henry Ford Health Sciences Center, Detroit, Michigan, USA.
Behav Genet. 1995 Mar;25(2):95-101. doi: 10.1007/BF02196920.
Recent epidemiologic studies have revealed that comorbidity of psychiatric disorders is far more pervasive than previously suspected. Strong associations have been reported between specific substance use disorders and between any mental disorder and any substance use disorder. This report focuses on comorbidity of nicotine dependence, a substance use disorder on which little epidemiologic information is available. Data come from an epidemiologic study of approximately 1000 young adults in southeast Michigan, in which the NIMH-DIS, revised according to DSM-III-R, was used. Lifetime prevalence of nicotine dependence was 20%. Males and females with nicotine dependence had increased odds for alcohol and illicit drug disorders, major depression, and anxiety disorders, compared with nondependent smokers and nonsmokers combined. Major depression and any anxiety disorder were associated specifically with nicotine dependence. Increased odds for alcohol or illicit drug disorders were observed also in nondependent smokers, compared to nonsmokers. History of early conduct problems increased the odds for nicotine dependence among smokers. Potential mechanisms in the comorbidity of nicotine dependence are discussed.
近期的流行病学研究表明，精神障碍的共病现象比之前所怀疑的更为普遍。已有报告指出特定物质使用障碍之间以及任何精神障碍与任何物质使用障碍之间存在密切关联。本报告聚焦于尼古丁依赖的共病情况，尼古丁依赖作为一种物质使用障碍，目前可得的流行病学信息较少。数据来源于对密歇根州东南部约1000名年轻成年人的一项流行病学研究，该研究使用了根据《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）进行修订的国家精神卫生研究所诊断访谈表（NIMH-DIS）。尼古丁依赖的终生患病率为20%。与非依赖吸烟者和非吸烟者的组合相比，有尼古丁依赖的男性和女性患酒精和非法药物障碍、重度抑郁症以及焦虑症的几率更高。重度抑郁症和任何焦虑症与尼古丁依赖存在特定关联。与非吸烟者相比，非依赖吸烟者患酒精或非法药物障碍的几率也有所增加。早期行为问题史增加了吸烟者中尼古丁依赖的几率。本文还讨论了尼古丁依赖共病现象中的潜在机制。
