title: Smoking and major depressive disorder in Chinese women.
abstract: OBJECTIVE
  To investigate the risk factors that contribute to smoking in female patients with major depressive disorder (MDD) and the clinical features in depressed smokers.
  
  
  METHODS
  We examined the smoking status and clinical features in 6120 Han Chinese women with MDD (DSM-IV) between 30 and 60 years of age across China. Logistic regression was used to determine the association between clinical features of MDD and smoking status and between risk factors for MDD and smoking status.
  
  
  RESULTS
  Among the recurrent MDD patients there were 216(3.6%) current smokers, 117 (2.0%) former smokers and 333(5.6%) lifetime smokers. Lifetime smokers had a slightly more severe illness, characterized by more episodes, longer duration, more comorbid illness (panic and phobias), with more DSM-IV A criteria and reported more symptoms of fatigue and suicidal ideation or attempts than never smokers. Some known risk factors for MDD were also differentially represented among smokers compared to non-smokers. Smokers reported more stressful life events, were more likely to report childhood sexual abuse, had higher levels of neuroticism and an increased rate of familial MDD. Only neuroticism was significantly related to nicotine dependence.
  
  
  CONCLUSIONS
  Although depressed women smokers experience more severe illness, smoking rates remain low in MDD patients. Family history of MDD and environmental factors contribute to lifetime smoking in Chinese women, consistent with the hypothesis that the association of smoking and depression may be caused by common underlying factors.
authors.affiliation: ShengJing Hospital of China Medical University, Heping District, Shenyang, Liaoning, P. R. China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: He
authors.affiliation: The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China.
authors.forename: Lei
authors.initials: L
authors.lastname: Yang
authors.affiliation: Shanghai Mental Health Center, Shanghai, P. R. China; Huashan Hospital of Fudan University, Shanghai, P. R. China.
authors.forename: Shenxun
authors.initials: S
authors.lastname: Shi
authors.affiliation: Chinese Traditional Hospital of Zhejiang, Hangzhou, Zhejiang, P. R. China.
authors.forename: Jingfang
authors.initials: J
authors.lastname: Gao
authors.affiliation: Xinhua Hospital of Zhejiang Province, Hangzhou, Zhejiang, P. R. China.
authors.forename: Ming
authors.initials: M
authors.lastname: Tao
authors.affiliation: No. 1 Hospital of Shanxi Medical University, Taiyuan, Shanxi, P. R. China.
authors.forename: Kerang
authors.initials: K
authors.lastname: Zhang
authors.affiliation: No. 1 Hospital of Medical College of Xian Jiaotong University, Xian, Shaanxi, P. R. China.
authors.forename: Chengge
authors.initials: C
authors.lastname: Gao
authors.affiliation: Jilin Brain Hospital, Siping, Jilin, P. R. China.
authors.forename: Lijun
authors.initials: L
authors.lastname: Yang
authors.affiliation: Mental Hospital of Jiangxi Province, Nanchang, Jiangxi, P. R. China.
authors.forename: Kan
authors.initials: K
authors.lastname: Li
authors.affiliation: Xian Mental Health Center, New Qujiang District, Xian, Shaanxi, P. R. China.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Shi
authors.affiliation: Beijing Anding Hospital of Capital University of Medical Sciences, Deshengmen wai, Xicheng District, Beijing, P. R. China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Shandong Mental Health Center, Jinan, Shandong, P. R. China.
authors.forename: Lanfen
authors.initials: L
authors.lastname: Liu
authors.affiliation: No. 3 Hospital of Sun Yat-sen University, Tianhe District, Guangzhou, Guangdong, P. R. China.
authors.forename: Jinbei
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Hebei Mental Health Center, Baoding, Hebei, P. R. China.
authors.forename: Bo
authors.initials: B
authors.lastname: Du
authors.affiliation: Chongqing Mental Health Center, Jiangbei District, Chongqing, P. R. China.
authors.forename: Guoqing
authors.initials: G
authors.lastname: Jiang
authors.affiliation: Tianjin Anding Hospital, Hexi District, Tianjin, P. R. China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Shen
authors.affiliation: No. 4 Hospital of Jiangsu University, Zhenjiang, Jiangsu, P. R. China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Psychiatric Hospital of Henan Province, Xinxiang, Henan, P. R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Liang
authors.affiliation: Nanjing Brain Hospital, Nanjing, Jiangsu, P. R. China.
authors.forename: Jing
authors.initials: J
authors.lastname: Sun
authors.affiliation: Harbin Medical University, Nangang District, Haerbin, Heilongjiang, P. R. China.
authors.forename: Jian
authors.initials: J
authors.lastname: Hu
authors.affiliation: Shenzhen Kang Ning Hospital, Luohu District, Shenzhen, Guangdong, P. R. China.
authors.forename: Tiebang
authors.initials: T
authors.lastname: Liu
authors.affiliation: First Hospital of Hebei Medical University, Shijiazhuang, Hebei, P. R. China.
authors.forename: Xueyi
authors.initials: X
authors.lastname: Wang
authors.affiliation: Guangzhou Brain Hospital (Guangzhou Psychiatric Hospital), Liwan District, Guangzhou, Guangdong, P. R. China.
authors.forename: Guodong
authors.initials: G
authors.lastname: Miao
authors.affiliation: No. 1 Hospital of Chongqing Medical University, Yuanjiagang, Yuzhong District, Chongqing, P. R. China.
authors.forename: Huaqing
authors.initials: H
authors.lastname: Meng
authors.affiliation: Dalian No. 7 Hospital, Ganjingzi District, Dalian, Liaoning, P. R. China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.affiliation: No. 3 Hospital of Heilongjiang Province, Beian, Heilongjiang, P. R. China.
authors.forename: Chunmei
authors.initials: C
authors.lastname: Hu
authors.affiliation: Wuhan Mental Health Center, Wuhan, Hubei, P. R. China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.affiliation: Sichuan Mental Health Center, Mianyang, Sichuan, P. R. China.
authors.forename: Guoping
authors.initials: G
authors.lastname: Huang
authors.affiliation: Mental Health Institute of Jining Medical College, Dai Zhuang, Bei Jiao, Jining, Shandong, P. R. China.
authors.forename: Gongying
authors.initials: G
authors.lastname: Li
authors.affiliation: Liaocheng No. 4 Hospital, Liaocheng, Shandong, P. R. China.
authors.forename: Baowei
authors.initials: B
authors.lastname: Ha
authors.affiliation: Mental Health Center of West China Hospital of Sichuan University, Wuhou District, Chengdu, Sichuan, P. R. China.
authors.forename: Hong
authors.initials: H
authors.lastname: Deng
authors.affiliation: Suzhou Guangji Hospital, Suzhou, Jiangsu, P. R. China.
authors.forename: Qiyi
authors.initials: Q
authors.lastname: Mei
authors.affiliation: Anhui Mental Health Center, Hefei, Anhui, P. R. China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhong
authors.affiliation: Ningbo Kang Ning Hospital, Zhenhai District, Ningbo, Zhejiang, P. R. China.
authors.forename: Shugui
authors.initials: S
authors.lastname: Gao
authors.affiliation: Changchun Mental Hospital, Changchun, Jilin, P. R. China.
authors.forename: Hong
authors.initials: H
authors.lastname: Sang
authors.affiliation: No. 2 Hospital of Lanzhou University, Lanzhou, Gansu, P. R. China.
authors.forename: Yutang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Fuzhou Psychiatric Hospital, Cangshan District, Fuzhou, Fujian, P. R. China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Fang
authors.affiliation: Harbin No. 1 Special Hospital, Haerbin, Heilongjiang, P. R. China.
authors.forename: Fengyu
authors.initials: F
authors.lastname: Yu
authors.affiliation: Jining Psychiatric Hospital, North Dai Zhuang, Rencheng District, Jining, Shandong, P. R. China.
authors.forename: Donglin
authors.initials: D
authors.lastname: Yang
authors.affiliation: No. 2 Xiangya Hospital of Zhongnan University, Furong District, Changsha, Hunan, P. R. China.
authors.forename: Tieqiao
authors.initials: T
authors.lastname: Liu
authors.affiliation: Xijing Hospital of No. 4 Military Medical University, Xian, Shaanxi, P. R. China.
authors.forename: Yunchun
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Mental Health Center of Shantou University, Shantou, Guangdong, P. R. China.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Hong
authors.affiliation: Tongji University Hospital, Shanghai, P. R. China.
authors.forename: Wenyuan
authors.initials: W
authors.lastname: Wu
authors.affiliation: Huaian No. 3 Hospital, Huaian, Jiangsu, P. R. China.
authors.forename: Guibing
authors.initials: G
authors.lastname: Chen
authors.affiliation: Huzhou No. 3 Hospital, Huzhou, Zhejiang, P. R. China.
authors.forename: Min
authors.initials: M
authors.lastname: Cai
authors.affiliation: Mudanjiang Psychiatric Hospital of Heilongjiang Province, Xinglong, Mudanjiang, Heilongjiang, P. R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Song
authors.affiliation: No. 1 Hospital of Jinan University, Guangzhou, Guangdong, P. R. China.
authors.forename: Jiyang
authors.initials: J
authors.lastname: Pan
authors.affiliation: Qingdao Mental Health Center, Shibei District, Qingdao, Shandong, P. R. China.
authors.forename: Jicheng
authors.initials: J
authors.lastname: Dong
authors.affiliation: Guangxi Longquanshan Hospital, Yufeng District, Liuzhou, P. R. China.
authors.forename: Runde
authors.initials: R
authors.lastname: Pan
authors.affiliation: Daqing No. 3 Hospital of Heilongjiang Province, Ranghulu district, Daqing, Heilongjiang, P. R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Tangshan No. 5 Hospital, Lunan District, Tangshan, Hebei, P. R. China.
authors.forename: Zhenming
authors.initials: Z
authors.lastname: Shen
authors.affiliation: Anshan Psychiatric Rehabilitation Hospital, Lishan District, Anshan, Liaoning, P. R. China.
authors.forename: Zhengrong
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Weihai Mental Health Center, ETDZ, Weihai, Shandong, P. R. China.
authors.forename: Danhua
authors.initials: D
authors.lastname: Gu
authors.affiliation: Renmin Hospital of Wuhan University, Wuchang District, Wuhan, Hubei, P. R. China.
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Wang
authors.affiliation: The First Hospital of China Medical University, Heping District, Shenyang, Liaoning, P. R. China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Tianjin First Center Hospital, Hedong District, Tianjin, P. R. China.
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Liu
authors.affiliation: Hainan Anning Hospital, Haikou, Hainan, P. R. China.
authors.forename: Qiwen
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom.
authors.forename: Yihan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Clinical Trial Service Unit, Richard Doll Building, Oxford, United Kingdom.
authors.forename: Yiping
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, United States of America.
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Kendler
authors.affiliation: ShengJing Hospital of China Medical University, Heping District, Shenyang, Liaoning, P. R. China.
authors.forename: Xumei
authors.initials: X
authors.lastname: Wang
authors.affiliation: The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China.
authors.forename: Youhui
authors.initials: Y
authors.lastname: Li
authors.affiliation: Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Flint
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology*; D012959:Socioeconomic Factors; D014029:Tobacco Use Disorder / Q000150:complications