title: Psychiatric disorders in smokers seeking treatment for tobacco dependence: relations with tobacco dependence and cessation.
abstract: 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.
authors.affiliation: Center for Tobacco Research and Intervention.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Piper
authors.affiliation: Center for Tobacco Research and Intervention.
authors.forename: Stevens S
authors.initials: SS
authors.lastname: Smith
authors.affiliation: Center for Tobacco Research and Intervention.
authors.forename: Tanya R
authors.initials: TR
authors.lastname: Schlam
authors.affiliation: Department of Family Medicine.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Fleming
authors.affiliation: Division of Public Health.
authors.forename: Amy A
authors.initials: AA
authors.lastname: Bittrich
authors.affiliation: Department of Pediatric Oncology.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Brown
authors.affiliation: Center for Tobacco Research and Intervention.
authors.forename: Cathlyn J
authors.initials: CJ
authors.lastname: Leitzke
authors.affiliation: Department of Industrial and Systems Engineering.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Zehner
authors.affiliation: Center for Tobacco Research and Intervention.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Fiore
authors.affiliation: Center for Tobacco Research and Intervention.
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Baker
mesh_terms: 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
chemical_list: D009538:Nicotine