Breslau N, Kilbey M M, Andreski P
Department of Biostatistics and Research Epidemiology, Henry Ford Hospital, Detroit, Mich 48202.
Arch Gen Psychiatry. 1993 Jan;50(1):31-5. doi: 10.1001/archpsyc.1993.01820130033006.
We examined prospectively the association between nicotine dependence and major depression (MDD). The following questions were addressed: (1) Are smokers with a history of MDD at increased risk for progression to nicotine dependence and more severe levels of dependence? (2) Are persons with a history of nicotine dependence at increased risk for MDD? A sample of 995 young adults were interviewed in 1989 and reinterviewed in 1990, 14 months later. The revised National Institute of Mental Health-Diagnostic Interview Schedule was used to ascertain DSM-III-R nicotine dependence and other substance use and psychiatric disorders. A history of MDD increased the risk for progression to nicotine dependence or more severe levels of dependence (odds ratio, 2.06; 95% confidence interval, 1.21 to 3.49). In addition, persons with a history of nicotine dependence had a higher rate of first-incidence MDD during the follow-up period than persons with no history of nicotine dependence (7.5% vs 3.2%; odds ratio, 2.45; 95% confidence interval, 1.17 to 5.15). The prospective data suggest that the association between nicotine dependence and MDD, observed previously in cross-sectional studies, might be either causal, with influences flowing in both directions, or, more probably, noncausal, reflecting the effects of common factors that predispose to both disorders.
我们前瞻性地研究了尼古丁依赖与重度抑郁症（MDD）之间的关联。探讨了以下问题：（1）有MDD病史的吸烟者发展为尼古丁依赖以及依赖程度更严重的风险是否增加？（2）有尼古丁依赖病史的人患MDD的风险是否增加？1989年对995名年轻人进行了访谈，并在14个月后的1990年进行了再次访谈。使用修订后的美国国立精神卫生研究所诊断访谈表来确定DSM-III-R尼古丁依赖以及其他物质使用和精神障碍。MDD病史增加了发展为尼古丁依赖或更严重依赖程度的风险（优势比，2.06；95%置信区间，1.21至3.49）。此外，有尼古丁依赖病史的人在随访期间首次发生MDD的比率高于无尼古丁依赖病史的人（7.5%对3.2%；优势比，2.45；95%置信区间，1.17至5.15）。前瞻性数据表明，之前在横断面研究中观察到的尼古丁依赖与MDD之间的关联可能是因果关系，且影响是双向的，或者更有可能是非因果关系，反映了易患这两种疾病的共同因素的影响。
