Fergusson D M, Lynskey M T, Horwood L J
Department of Psychological Medicine, Christchurch School of Medicine, New Zealand.
Arch Gen Psychiatry. 1996 Nov;53(11):1043-7. doi: 10.1001/archpsyc.1996.01830110081010.
There has been growing interest in the associations between cigarette smoking and symptoms of depression. This study documents the comorbidity between depression and nicotine dependence in a birth cohort of 16-year-olds and examines the extent to which comorbidity between depression and nicotine dependence could be explained by risk factors associated with both outcomes.
Data were gathered during the course of a 16-year longitudinal study of a birth cohort of 947 New Zealand children for (1) depressive disorders and nicotine dependence at age 16 years; and (2) prospectively measured risk factors including family social position, family history of criminality, parental smoking, life events, parental attachment, conduct problems, self-esteem, and affiliations with delinquent peers.
There was evidence of moderate to strong comorbidity between depression and nicotine dependence at age 16 years; teenagers with a depressive disorder had odds of nicotine dependence that were 4.6 times those of teenagers without depressive disorder. Analyses using logistic regression and log-linear modeling methods revealed that a substantial component of the comorbidity between depression and nicotine dependence was explained by common or correlated risk factors associated with both outcomes. After adjustment for common or correlated risk factors, the adjusted odds ratio between depression and nicotine dependence was 2.3.
Comorbidities between depression and nicotine dependence seem to be well established by the age of 16 years. Much of this comorbidity can be explained by common or correlated risk factors associated with depression or nicotine dependence.
吸烟与抑郁症状之间的关联已引起越来越多的关注。本研究记录了一个16岁出生队列中抑郁症与尼古丁依赖的共病情况，并考察了抑郁症与尼古丁依赖之间的共病在多大程度上可由与这两种结果相关的危险因素来解释。
在一项对947名新西兰儿童出生队列进行的为期16年的纵向研究过程中收集数据，内容包括：（1）16岁时的抑郁障碍和尼古丁依赖情况；（2）前瞻性测量的危险因素，包括家庭社会地位、犯罪家族史、父母吸烟情况、生活事件、父母依恋关系、行为问题、自尊以及与不良同伴的交往。
有证据表明16岁时抑郁症与尼古丁依赖之间存在中度至重度共病情况；患有抑郁障碍的青少年尼古丁依赖的几率是未患抑郁障碍青少年的4.6倍。使用逻辑回归和对数线性建模方法进行的分析显示，抑郁症与尼古丁依赖之间共病的很大一部分可由与这两种结果相关的共同或相关危险因素来解释。在对共同或相关危险因素进行调整后，抑郁症与尼古丁依赖之间的调整优势比为2.3。
抑郁症与尼古丁依赖之间的共病情况在16岁时似乎已充分显现。这种共病情况的很大一部分可由与抑郁症或尼古丁依赖相关的共同或相关危险因素来解释。
