2009, Number 3
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Salud Mental 2009; 32 (3)
Association between smoking and minimal–mild depressive symptomatology in heavy smokers
Moreno CA, Ruiz VS, Medina-Mora Icaza ME
Language: Spanish
References: 196
Page: 199-204
PDF size: 108.01 Kb.
ABSTRACT
The World Health Organization (WHO) estimates that by the year 2020 tobacco addiction will be responsible for 10 million deaths, seventy percent of which will occur in underdeveloped countries. On the other hand, depression affects about 121 million people worldwide, and is projected to reach a second place in the ranking of Disability Adjusted Life Years (DALYs) calculated for all ages and both sexes by the year 2020. In Mexico, 14 million people are current smokers and 9.6 million are former smokers, according to the 2002 National Addictions Survey, and almost four million people are diagnosed with depression. Both disorders are classified among the main causes of mortality and disability in Mexico. By gender, major depression in females is the second most prevalent disorder. Two percent of the Mexican population (two million people) present at least one major depressive episode before reaching the age of 18. Several studies have found an important link between depression and smoking. More recently, it was eported that the manifestation of depressive symptomatology predicts smoking addiction. Although the strong association between affective disorders and drug abuse has been documented, they are generally treated independently. For this reason, the need for integral management of comorbid diseases has been highlighted. Little is known about specific populations of patients that simultaneously manifest both disorders, and more knowledge is needed in order to design precise integral treatments for this kind of patients, taking into consideration the gender, severity of depression and level of nicotine dependence. The aim of this study was to describe the association between depressive symptoms, sociodemographic characteristics, and pattern of tobacco consumption of heavy smokers with minimal-mild depressive symptomatology in order to adjust for these relations in a later longitudinal regression analysis after these subjects have been assigned to different conditions of a new integral treatment to quit smoking. A total of 89 heavy smokers were assessed; 74 of them (83%) had minimal-mild depressive symptomatology; there were 35 females and 39 males, with an average age of 44.3 yrs. Level of tobacco addiction was determined by the Fagerström Test for Nicotine Dependence, and the Beck Depression Inventory was used to assess depressive symptomatology. By means of regression models, we found an increase of the depressive symptomatology related to the severity of tobacco addiction (p= .025). Those with a bachelor’s educational level, had less depressive symptomatology (p= .025). The high frequency of depressive symptomatology and the protective factor of schooling concur with findings reported in other studies. The better understanding of the characteristics of smokers with different levels of tobacco consumption and depressive symptomatology is suggested. It is important to gain knowledge on the particular characteristics of specific groups of smokers for the development of new treatments that can simultaneously treat smoking addiction and depression, and can also help to norm criteria for their treatment.
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global_burden_disease/en/index.html
Secretaría de Salud, Instituto Nacional de Estadística, Geografía e Informática.
Encuesta Nacional de Adicciones 2002. México, DF: Consejo
Nacional de Adicciones; 2002.
Secretaría de Salud. Plan Nacional de Salud 2001-2006. México, DF: Secretaría
Secretaría de Salud. Programa específico de depresión. México, DF: Servicios
Medina-Mora ME, Borges G, Lara C, Benjet C, Blanco J et al. Prevalence,
service use, and demographic correlates of 12-month DSM-IV
psychiatric disorders in Mexico: results from the Mexican National Comorbidity
Survey. Psychol Med 2005;35:1773-1783.
Breslau N, Kilbey M, Andreski P. Nicotine withdrawal symptoms and
psychiatric disorders: findings from an epidemiological study of young
adults. Am J Psychiatry 1992;149:464- 469.
Breslau N, Kilbey M, Andreski P. Nicotine dependence and major depression:
new evidence from a prospective investigation. Arch Gen
Psychiatry 1993;50:31-35.
Breslau N, Novak SP, Kessler RC. Psychiatric disorders and stages of
smoking. Biol Psychiatry 2004;55:69-76.
Glassman A, Helzer JE, Covey LS. Smoking, smoking cessation and
major depression. JAMA 1990;264:1546-1594.
Stage KB, Glassman AH, Covey LS. Depression after smoking cessation:
case reports. J Clin Psychiatry 1996;57:467-469.
Lyons M, Hitsman B, Xian H, Panizzon MS, Jerskey BA et al. A twin
study of smoking, nicotine dependance, and major depression in men.
Nicotine Tob Res 2008;10:97-108.
Wiesbeck GA, Kuhl HC, Yaldizili O, Wurst FM. Tobacco smoking and
depresión- results from the WHO/ISBRA study, Neuropsychobiology
Glassman A, Covey LS, Stetner F, Rivelli S. Smoking cessation and
the course of major depression: a follow-up study. Lancet
Munafò MR, Hitsman B, Rende R, Metcalfe C, Niaura R. Effects of progression
to cigarette smoking on depressed mood in adolescents: evidence
from the National Longitudinal Study of Adolescent Health.
Addiction 2008;103:162-171.
Medina-Mora ME, Borges G, Lara C, Benjet C. La salud mental en México
y los retos para su atención. Resultados de la Encuesta Nacional de Epidemiología
Psiquiátrica. Manual de Trastornos Mentales. México: Asociación
Psiquiátrica Mexicana AC; 2006.
Benjet C, Borges GG, Medina-Mora ME, Fleiz-Bautista C, Zambrano-
Ruiz J. La depresión con inicio temprano: prevalencia, curso natural y
latencia para buscar tratamiento. Salud Publica Mex 2004;46(5):17-24.
Foulds J, Steinberg MB, Williams JM, Ziedonis DM. Developments in
pharmacotherapy for tobacco dependence: past, present and future.
Drug Alcohol Rev 2008;25:59-71.
Saxon AJ, Baer JS, Davis TM, Sloan KL, Malte CA et al. Smoking cessation
treatment among dually diagnosed individuals: preliminary evaluation
of different pharcotherapies. Nicotine Tob Res 2003;5(4):589-596.
Lai I, Hong Ch, Tsai S. Association study of nicotinic-receptor variants
and major depressive disorder. J Affect Disord 2001;66:79-82.
Pomerleau CS. Co-factors for smoking and evolutionary psychobiology.
Addiction 1997;92(4):397-408.
Salín-Pascual R, de la Fuente JR, Galicia-Polo L, Drucker-Colín R. Effects
of transdermal nicotine on mood and sleep in nonsmoking major depressed
patients. Psychopharmacology 1995;121:476-479.
Salín-Pascual R, Drucker-Colín R. A novel effect of nicotine on mood
and sleep in major depression. Neuroreport 1998;9:57-60.
Moreno-Coutiño A, Calderón-Ezquerro C, Drucker-Colín R. Long term
changes in sleep and depressive symptoms of smokers in abstinente.
Nicotine Tob Res 2007;9:389-396.
Catley D, Harris KJ, Okuyemi KS, Mayo MS, Pankey E et al. The influence
of depressive symptoms on smoking cessation among African
Americans in a randomized trial of bupropion. Nicotine Tob Res
Haug NA, Hall SM, Prochaska JJ. Acceptance of nicotine dependence
treatment among currently depressed smokers. Nicotine Tob Res
Mihailescu S, Drucker-Colín R. Nicotine, brain nicotinic receptors, and
neuropsychiatric disorders. Arch Med Res 2000;31:131-144.
Aveyard P, Johnson C, Fillingham S, Parsons A, Murphy M. Nortriptyline
plus nicotine replacement versus placebo plus nicotine replacement
for smoking cessation: pragmatic randomized controlled trial. Br
Med J 2008;336:1223-1227.
Glover ED, Glover PN. Pharmacologic treatments for the nicotine dependent
smoker. Am J Health Behav 2001;25(3):179-182.
Hitsman B, Pingitore R, Spring B, Mahableshwarkar A, Mizes JS et al.
Antidepressant pharmacotherapy helps some cigarette smokers more
than others. J Consult Clin Psychol 1999;67:547-554.
Hughes JR. Depression during tobacco abstinence. Nicotine Tob Res
Hurt RD, Sachs DP, Glover ED, Offord KP, Johnston JA, et al. A comparison
of sustained-release bupropion and placebo for smoking cessation.
N Engl J Med 1997;337:1195-1202.
Lerman C, Niaura R, Collins BN. Effect of bupropion on depression
symptoms in a smoking cessation clinical trial. Psychol Addict Behav
Heatherton T, Kozlowski L, Frecker R, Fagerström K. The Fagerström
Test for Nicotine Dependence: a revision of the Fagerström Tolerance
Questionnarie. Br J Adict 1991;86:1119-1127.
Jurado S, Villegas ME, Méndez L, Rodríguez F, Loperena V et al. La
estandarización del Inventario de Depresión de Beck para los residentes
de la Ciudad de México. Salud Mental 1998;21:26-31.
Beck, CT, Froman RD, Bernal H. Acculturation level and postpartum depression
in Hispanic mothers. Am J Matern Child Nurs 2005;30:299-204.
Becoña E, Vázquez FL. The Fargestrom Test for Nicotine Dependence
in a Spanish sample. Psychol Rep 1998;83:1455-1458.
Esquivel-Molina CG, Buendía-Cano F, Martínez-García O, Martínez-
Mendoza JA, Martínez-Ordaz VA et al. Burnout syndrome in medical
staff affiliated to a tertiary care hospital. Rev Med Inst Mex Seguro Soc
Lara-Rivas G, Ramírez-Venegas A, Sansores-Martínez R, Espinoza A,
Regalado J. Indicadores de síntomas de abstinencia en un grupo de fumadores
mexicanos. Salud Publica Mex 2007;49:257-262.
Salín-Pascual RJ, Basañes-Villa E. Changes in compulsion and anxiety
symptoms with nicotine transdermal patches in non-smoking obsessive-
compulsive disorder patients. Rev Invest Clin 2003;55:650-654.
Hutchinson J, Tizabi Y, Taylor R. Rapid method for the simultaneous
measurement of nicotine and continine in urine and serum by gas chromatography-
mass spectrometry. J Chromatogr B Analyt Technol Biomed
Benjet C, Wagner FA, Borges GG, Medina-Mora ME. The relationship
of tobacco smoking with depressive symptomatology in the Third Mexican
National Addictions Survey. Psychol Med 2004;34(5):881-888.
Cavelaars AE, Kunst AE, Geurts JJ, Crialesi R, Grötvedt L, et al. Educational
differences in smoking: International comparison. Br Med J
Ochoa A, Enamorado N. Incidencia de pacientes fumadores en un grupo
poblacional. Rev Cubana Enferm 2004;20(3) [Consult October 3th
2008] Available at: http://scieloprueba.sld.cu
Okuyemi KS, Ahluwalia JS, Harris KJ. Pharmacotherapy of smoking
cessation. Arch Fam Med 2000;9:270-281.
Cornuz J, Pinget C, Gilbert A, Paccaud F. Cost-effectiveness analysis of
the first-line therapies for nicotine dependence. Eur J Cli Pharmacol
Cornuz J, Gilbert A, Pinget C, McDonald P, Slama K et al. Cost-effectiveness
of pharmacotherapies for nicotine dependence in primary care
settings: a multinational comparison. Tob Control 2006;15:152-159.
Covey LS, Glassman AH, Stetner F. Cigarette smoking and major depression.
J Addic Dis 1998;17:35-46.
Durcan MJ, White J, Jorenby DE, Fiore MC, Rennard SI et al. Impact of
prior nicotine replacement therapy on smoking cessation efficacy. Am J
Health Behav 2002;26(3):213-20.
Etter JF, Stapleton JA. Nicotine replacement therapy for long-term smoking
cessation: a meta-analysis. Tob Control 2006; 15(4):280-285.
Fiore MC, Thompson SA, Lawrence DL, Welsch S, Andrews K et al.
Helping Wisconsin women quit smoking: a successful collaboration. Wis
Thase ME, Haight BR, Richard N, Rockett CB, Mitton M et al. Remission
rates following antidepressant therapy with bupropion or selective serotonin
reuptake inhibitors: a meta-analysis of original data from 7 randomized
controlled trials. J Clin Psychiatry 2005;66(8):974-981.
World Health Organization. Global burden of disease. Geneva 2007 [consult October 12th 2008] Available at: http://www.who.int/healthinfo/ global_burden_disease/en/index.html
Secretaría de Salud, Instituto Nacional de Estadística, Geografía e Informática. Encuesta Nacional de Adicciones 2002. México, DF: Consejo Nacional de Adicciones; 2002.
Secretaría de Salud. Plan Nacional de Salud 2001-2006. México, DF: Secretaría de Salud; 2001.
Secretaría de Salud. Programa específico de depresión. México, DF: Servicios de Salud Mental; 2002.
Medina-Mora ME, Borges G, Lara C, Benjet C, Blanco J et al. Prevalence, service use, and demographic correlates of 12-month DSM-IV psychiatric disorders in Mexico: results from the Mexican National Comorbidity Survey. Psychol Med 2005;35:1773-1783.
Breslau N, Kilbey M, Andreski P. Nicotine withdrawal symptoms and psychiatric disorders: findings from an epidemiological study of young adults. Am J Psychiatry 1992;149:464- 469.
Breslau N, Kilbey M, Andreski P. Nicotine dependence and major depression: new evidence from a prospective investigation. Arch Gen Psychiatry 1993;50:31-35.
Breslau N, Novak SP, Kessler RC. Psychiatric disorders and stages of smoking. Biol Psychiatry 2004;55:69-76.
Glassman A, Helzer JE, Covey LS. Smoking, smoking cessation and major depression. JAMA 1990;264:1546-1594.
Stage KB, Glassman AH, Covey LS. Depression after smoking cessation: case reports. J Clin Psychiatry 1996;57:467-469.
Lyons M, Hitsman B, Xian H, Panizzon MS, Jerskey BA et al. A twin study of smoking, nicotine dependance, and major depression in men. Nicotine Tob Res 2008;10:97-108.
Wiesbeck GA, Kuhl HC, Yaldizili O, Wurst FM. Tobacco smoking and depresión- results from the WHO/ISBRA study, Neuropsychobiology 2008;57:26-31.
Glassman A, Covey LS, Stetner F, Rivelli S. Smoking cessation and the course of major depression: a follow-up study. Lancet 2001;357:1929-1932.
Munafò MR, Hitsman B, Rende R, Metcalfe C, Niaura R. Effects of progression to cigarette smoking on depressed mood in adolescents: evidence from the National Longitudinal Study of Adolescent Health. Addiction 2008;103:162-171.
Medina-Mora ME, Borges G, Lara C, Benjet C. La salud mental en México y los retos para su atención. Resultados de la Encuesta Nacional de Epidemiología Psiquiátrica. Manual de Trastornos Mentales. México: Asociación Psiquiátrica Mexicana AC; 2006.
Benjet C, Borges GG, Medina-Mora ME, Fleiz-Bautista C, Zambrano- Ruiz J. La depresión con inicio temprano: prevalencia, curso natural y latencia para buscar tratamiento. Salud Publica Mex 2004;46(5):17-24.
Foulds J, Steinberg MB, Williams JM, Ziedonis DM. Developments in pharmacotherapy for tobacco dependence: past, present and future. Drug Alcohol Rev 2008;25:59-71.
Saxon AJ, Baer JS, Davis TM, Sloan KL, Malte CA et al. Smoking cessation treatment among dually diagnosed individuals: preliminary evaluation of different pharcotherapies. Nicotine Tob Res 2003;5(4):589-596.
Lai I, Hong Ch, Tsai S. Association study of nicotinic-receptor variants and major depressive disorder. J Affect Disord 2001;66:79-82.
Pomerleau CS. Co-factors for smoking and evolutionary psychobiology. Addiction 1997;92(4):397-408.
Salín-Pascual R, de la Fuente JR, Galicia-Polo L, Drucker-Colín R. Effects of transdermal nicotine on mood and sleep in nonsmoking major depressed patients. Psychopharmacology 1995;121:476-479.
Salín-Pascual R, Drucker-Colín R. A novel effect of nicotine on mood and sleep in major depression. Neuroreport 1998;9:57-60.
Moreno-Coutiño A, Calderón-Ezquerro C, Drucker-Colín R. Long term changes in sleep and depressive symptoms of smokers in abstinente. Nicotine Tob Res 2007;9:389-396.
Catley D, Harris KJ, Okuyemi KS, Mayo MS, Pankey E et al. The influence of depressive symptoms on smoking cessation among African Americans in a randomized trial of bupropion. Nicotine Tob Res 2005;7:859-870.
Haug NA, Hall SM, Prochaska JJ. Acceptance of nicotine dependence treatment among currently depressed smokers. Nicotine Tob Res 2005;7:217-224.
Mihailescu S, Drucker-Colín R. Nicotine, brain nicotinic receptors, and neuropsychiatric disorders. Arch Med Res 2000;31:131-144.
Aveyard P, Johnson C, Fillingham S, Parsons A, Murphy M. Nortriptyline plus nicotine replacement versus placebo plus nicotine replacement for smoking cessation: pragmatic randomized controlled trial. Br Med J 2008;336:1223-1227.
Glover ED, Glover PN. Pharmacologic treatments for the nicotine dependent smoker. Am J Health Behav 2001;25(3):179-182.
Hitsman B, Pingitore R, Spring B, Mahableshwarkar A, Mizes JS et al. Antidepressant pharmacotherapy helps some cigarette smokers more than others. J Consult Clin Psychol 1999;67:547-554.
Hughes JR. Depression during tobacco abstinence. Nicotine Tob Res 2007;9:443-446.
Hurt RD, Sachs DP, Glover ED, Offord KP, Johnston JA, et al. A comparison of sustained-release bupropion and placebo for smoking cessation. N Engl J Med 1997;337:1195-1202.
Lerman C, Niaura R, Collins BN. Effect of bupropion on depression symptoms in a smoking cessation clinical trial. Psychol Addict Behav 2004;18:362-366.
Heatherton T, Kozlowski L, Frecker R, Fagerström K. The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnarie. Br J Adict 1991;86:1119-1127.
Jurado S, Villegas ME, Méndez L, Rodríguez F, Loperena V et al. La estandarización del Inventario de Depresión de Beck para los residentes de la Ciudad de México. Salud Mental 1998;21:26-31.
Beck, CT, Froman RD, Bernal H. Acculturation level and postpartum depression in Hispanic mothers. Am J Matern Child Nurs 2005;30:299-204.
Becoña E, Vázquez FL. The Fargestrom Test for Nicotine Dependence in a Spanish sample. Psychol Rep 1998;83:1455-1458.
Esquivel-Molina CG, Buendía-Cano F, Martínez-García O, Martínez-Mendoza JA, Martínez-Ordaz VA et al. Burnout syndrome in medical staff affiliated to a tertiary care hospital. Rev Med Inst Mex Seguro Soc 2007;45:427-436.
Lara-Rivas G, Ramírez-Venegas A, Sansores-Martínez R, Espinoza A, Regalado J. Indicadores de síntomas de abstinencia en un grupo de fumadores mexicanos. Salud Publica Mex 2007;49:257-262.
Salín-Pascual RJ, Basañes-Villa E. Changes in compulsion and anxiety symptoms with nicotine transdermal patches in non-smoking obsessive- compulsive disorder patients. Rev Invest Clin 2003;55:650-654.
Hutchinson J, Tizabi Y, Taylor R. Rapid method for the simultaneous measurement of nicotine and continine in urine and serum by gas chromatography- mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 1998;708:87-93.
Benjet C, Wagner FA, Borges GG, Medina-Mora ME. The relationship of tobacco smoking with depressive symptomatology in the Third Mexican National Addictions Survey. Psychol Med 2004;34(5):881-888.
Cavelaars AE, Kunst AE, Geurts JJ, Crialesi R, Grötvedt L, et al. Educational differences in smoking: International comparison. Br Med J 2000;320:1102-1107.
Ochoa A, Enamorado N. Incidencia de pacientes fumadores en un grupo poblacional. Rev Cubana Enferm 2004;20(3) [Consult October 3th 2008] Available at: http://scieloprueba.sld.cu
Okuyemi KS, Ahluwalia JS, Harris KJ. Pharmacotherapy of smoking cessation. Arch Fam Med 2000;9:270-281.
Cornuz J, Pinget C, Gilbert A, Paccaud F. Cost-effectiveness analysis of the first-line therapies for nicotine dependence. Eur J Cli Pharmacol 2003;59(3):201-206.
Cornuz J, Gilbert A, Pinget C, McDonald P, Slama K et al. Cost-effectiveness of pharmacotherapies for nicotine dependence in primary care settings: a multinational comparison. Tob Control 2006;15:152-159.
Covey LS, Glassman AH, Stetner F. Cigarette smoking and major depression. J Addic Dis 1998;17:35-46.
Durcan MJ, White J, Jorenby DE, Fiore MC, Rennard SI et al. Impact of prior nicotine replacement therapy on smoking cessation efficacy. Am J Health Behav 2002;26(3):213-20.
Etter JF, Stapleton JA. Nicotine replacement therapy for long-term smoking cessation: a meta-analysis. Tob Control 2006; 15(4):280-285.
Fiore MC, Thompson SA, Lawrence DL, Welsch S, Andrews K et al. Helping Wisconsin women quit smoking: a successful collaboration. Wis Med J 2000;99(2):68-72.
Thase ME, Haight BR, Richard N, Rockett CB, Mitton M et al. Remission rates following antidepressant therapy with bupropion or selective serotonin reuptake inhibitors: a meta-analysis of original data from 7 randomized controlled trials. J Clin Psychiatry 2005;66(8):974-981.
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