title: Increasing diagnosis of nicotine dependence in adolescent mental health patients.
abstract: OBJECTIVE
  The aim of this study was to investigate the routine recording patterns of patients' smoking by clinical staff of an adolescent mental health service over a 3-year period.
  
  
  METHODS
  A systematic examination of the clinical files of all patients who underwent an initial assessment or reassessment at the Youth Specialty Service (Mental Health; YSS) over a 2-month period (1 April-31 May) was carried out in 1996, 1997 and 1998. A range of data were collected including: demographics; diagnoses; amount of total information recorded and history of nicotine dependence.
  
  
  RESULTS
  A stable historical record of cigarette smoking in the region of 30-40% across the 3 years sampled was found, but the rate of formal diagnosis of nicotine dependence rose from 3.6% in 1996 to 26.3% in 1998. This rise was in the context of relative stability over this time period of: size of reports and relevant sections (alcohol and drug history, cigarette smoking history); three other key diagnoses, major depression, conduct disorder and alcohol dependence; and demographic data. The rise in rate of diagnosis proceeded specific discussion within the clinical team about nicotine dependence.
  
  
  CONCLUSIONS
  Adolescent mental health settings are a key venue to address heavy and potentially chronic cigarette smoking, but nicotine dependence has been traditionally a neglected diagnosis in mental health patients. The rate of diagnosis is likely to rise when specific discussion is undertaken within clinical teams.
authors.affiliation: National Centre for Treatment Development (Alcohol, Drugs and Addiction), Department of Psychological Medicine, Christchurch School of Medicine, New Zealand. dsellman@chmeds.ac.nz
authors.forename: J D
authors.initials: JD
authors.lastname: Sellman
authors.forename: A R
authors.initials: AR
authors.lastname: Wootton
authors.forename: D B
authors.initials: DB
authors.lastname: Stoner
authors.forename: D E
authors.initials: DE
authors.lastname: Deering
authors.forename: B J
authors.initials: BJ
authors.lastname: Craig
mesh_terms: D000293:Adolescent; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D009520:New Zealand / Q000453:epidemiology; D009538:Nicotine; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D009538:Nicotine