Psychiatric disorders in smokers seeking treatment for tobacco dependence: relations with tobacco dependence and cessation.
OBJECTIVE
The present research examined the relation of psychiatric disorders to tobacco dependence and cessation outcomes.


METHODS
Data were collected from 1,504 smokers (58.2% women; 83.9% White; mean age = 44.67 years, SD = 11.08) making an aided smoking cessation attempt as part of a clinical trial. Psychiatric diagnoses were determined with the Composite International Diagnostic Interview structured clinical interview. Tobacco dependence was assessed with the Fagerström Test of Nicotine Dependence (FTND) and the Wisconsin Inventory of Smoking Dependence Motives (WISDM).


RESULTS
Diagnostic groups included those who were never diagnosed, those who had ever been diagnosed (at any time, including in the past year), and those with past-year diagnoses (with or without prior diagnosis). Some diagnostic groups had lower follow-up abstinence rates than did the never diagnosed group (ps < .05). At 8 weeks after quitting, strong associations were found between cessation outcome and both past-year mood disorder and ever diagnosed anxiety disorder. At 6 months after quitting, those ever diagnosed with an anxiety disorder (OR = .72, p = .02) and those ever diagnosed with more than one psychiatric diagnosis (OR = .74, p = .03) had lower abstinence rates. The diagnostic categories did not differ in smoking heaviness or the FTND, but they did differ in dependence motives assessed with the WISDM.


CONCLUSIONS
Information on recent or lifetime psychiatric disorders may help clinicians gauge relapse risk and may suggest dependence motives that are particularly relevant to affected patients. These findings also illustrate the importance of using multidimensional tobacco dependence assessments.
Piper
Megan E
ME
Center for Tobacco Research and Intervention.
Smith
Stevens S
SS
Center for Tobacco Research and Intervention.
Schlam
Tanya R
TR
Center for Tobacco Research and Intervention.
Fleming
Michael F
MF
Department of Family Medicine.
Bittrich
Amy A
AA
Division of Public Health.
Brown
Jennifer L
JL
Department of Pediatric Oncology.
Leitzke
Cathlyn J
CJ
Center for Tobacco Research and Intervention.
Zehner
Mark E
ME
Department of Industrial and Systems Engineering.
Fiore
Michael C
MC
Center for Tobacco Research and Intervention.
Baker
Timothy B
TB
Center for Tobacco Research and Intervention.
D000328:Adult; D001008:Anxiety Disorders / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D009042:Motivation; D009538:Nicotine / Q000627:therapeutic use; D018579:Patient Selection; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000150:complications* / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome
D009538:Nicotine