Depression and the Dynamics of Smoking

Anda, Robert F.; Williamson, David F.; Escobedo, Luis G.; Mast, Eric E.; Giovino, Gary A.; Remington, Patrick L.

doi:10.1001/jama.1990.03450120053028

Cited by 714 publications

(176 citation statements)

References 28 publications

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“…A high prevalence of depression (46.7%) was observed in the population studied, higher than the one found in other studies conducted with ACS patients, whose results ranged from 15 to 44% 3,5,14,15 . This difference cannot be explained by the age factor, since it was very similar to that of other studies 3,5 .…”

Section: Discussioncontrasting

confidence: 67%

“…Discouragement, apathy, intolerance to frustrations and inflexible thinking, all typical of depressed mood, create unfavorable conditions that make the patient unmotivated to comply with drug therapy and change in lifestyle. Additionally, the physiological changes associated with depression, such as enhanced platelet aggregation, sympathoadrenal hyperactivity, reduction in heart rate variability and decrease in ventricular fibrillation threshold, directly affect the progression of CHD 15 . These pathophysiological mechanisms, together with failure to comply with treatment and changes in lifestyle, account for the higher risks of myocardial infarction (MI) recurrence and increased mortality rates among depressed patients.…”

Section: Resultsmentioning

confidence: 99%

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Depressão e síndromes isquêmicas miocárdicas instáveis: diferenças entre homens e mulheres

Perez¹,

Nicolau²,

Romano³

et al. 2005

Arq. Bras. Cardiol.

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OBJECTIVEInvestigate whether social and demographic characteristics, clinical diagnosis, smoking status, alcohol consumption, and anxiety are associated with depression in patients with Acute Coronary Syndromes (ACS) stratified by gender. METHODSThree hundred forty-five consecutive patients with unstable myocardial ischemic syndrome (206 with myocardial infarction and 139 with unstable angina) were interviewed. The interviews included questions about sociodemographics, smoking status, screening for depression (Prime MD e BDI), trait and state anxiety, (IDATE), and alcohol consumption (AUDIT). RESULTSDiagnosis of depression has significantly correlated with female gender, age under 50 years, and higher average scores on trait anxiety and state anxiety. Depressed men (245) were usually younger than 50 years of age, smokers and had higher average score on trait anxiety and state anxiety than those non-depressed. The multivariate analysis highlights that age is negatively associated with depression (OR 0.9519 95% CI 0.9261 -0.9784) and that higher scores on trait anxiety are positively associated (OR 1.0691 95% CI 1.0375 -1.1017) with depression in the male gender. In the female sample (100), depressed women differ from nondepressed women in that they have a higher average score on trait anxiety and state anxiety. In the multivariate analysis of the female sample, a higher score on trait anxiety was independently associated with depression (OR 1.1267 95% CI 1.0632 -1.1940). CONCLUSIONIt was concluded that, among hospitalized patients with ACS, women, as well as men under 50 years and who suffer from anxiety are more likely to experience depression.

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Section: Discussioncontrasting

confidence: 67%

Section: Resultsmentioning

confidence: 99%

Depressão e síndromes isquêmicas miocárdicas instáveis: diferenças entre homens e mulheres

Perez¹,

Nicolau²,

Romano³

et al. 2005

Arq. Bras. Cardiol.

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“…Further, the only association with cancer was observed in mothers of offspring with schizophrenia, who had an elevated risk for lung cancer. This finding may reflect a stress-induced increase in the amount smoked (Anda et al, 1990).…”

Section: Discussionmentioning

confidence: 83%

Major life event – diagnosis of schizophrenia in offspring and risk for cancer

et al. 2004

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The overall risk for cancer among 19 856 parents of schizophrenic patients in Denmark was not increased; however, a 30% increased risk for lung cancer was observed in mothers (95% confidence interval, 1.03 -1.61), suggesting an indirect effect on cancer risk mediated by life-style factors. The belief that psychological stress causes cancer has a long history, but scientific evidence remains contradictory to date (Fox, 1995;Dalton et al, 2002). Psychological stress has effects on the endocrine and immune systems, which might enhance neoplastic growth by increasing the levels of corticosterone, prolactin or estrogen, or by decreasing the number and activity of lymphocytes and natural killer cells (Ader et al, 1995;Kiecolt-Glaser et al, 2002). Stress could also increase adverse life-style behaviours like smoking and heavy alcohol drinking, which over time increase cancer incidence (Smith and Gallo, 2000).A son or daughter with severe mental illness, such as schizophrenia, is associated with significant grief, sorrow and feeling of loss constituting psychological distress among family members (Czuchta and McCay, 2001;Martens and Addington, 2001). We investigated the effect of the diagnosis of schizophrenia in a son or daughter as an indicator of psychological stress on overall and specific cancer incidence among their parents in a population-based study based on nationwide registers with complete and unbiased information on both exposure and outcomes of interest. MATERIALS AND METHODSFrom the nationwide Danish Central Population Register (CPR) we identified all 2 013 848 parents born in Denmark, alive on 1 April 1969 whose children were born after 1935 and were living between 1 April 1969 and 1 January 1983. Only parents whose children were over the age of 15 years at the termination of follow-up on 31 December 1997 were included since less than 1.5% of schizophrenia cases develop before that age (Westergaard et al, 1999). The CPR was established in 1968 and all residents of Denmark were assigned a unique identification number that permits accurate linkage between registries.By linkage to the nationwide Danish Psychiatric Central Register, which contains information on all psychiatric admissions since 1969 (Munk-Joergensen and Mortensen, 1997), we identified and excluded 6676 parents who had been admitted for schizophrenia according to the International Classification of Diseases 8th revision between 1969 and 1993 (ICD-8, 295) and the 10th revision between 1993 and 1997 (ICD-10, F20; F25). Further, 10 466 offspring of the remaining parents were identified in the Danish Psychiatric Central Register with a diagnosis of schizophrenia; their parents constituted the exposed cohort.We used the nationwide Danish Cancer Registry, which contains information on all cancer diagnosed in Denmark since 1943 coded according to a modified Danish version of the ICD-7 (Storm et al, 1997), to identify parents who developed a first primary cancer between 1 April 1969 or the day when the offspring reached 15 years (study entry), whichev...

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“…A longitudinal study in teenagers found that depression increased susceptibility to peer pressure to begin smoking (33). Diabetes guidelines strongly recommend that patients with diabetes stop smoking, but Anda et al (34) showed that over a 9-year period, smokers with depression were 40% less likely to quit than nondepressed smokers. Smokers with a history of depression versus those without a history of affective disorders were found to be more likely to develop a major depressive episode when they tried to quit smoking (35).…”

Section: Results -mentioning

confidence: 99%

Behavioral and Clinical Factors Associated With Depression Among Individuals With Diabetes

et al. 2004

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OBJECTIVE -The goal of this study was to determine the behavioral and clinical characteristics of diabetes that are associated with depression after controlling for potentially confounding variables. RESEARCH DESIGN AND METHODS-A population-based mail survey was sent to patients with diabetes from nine primary care clinics of a health maintenance organization. The Patient Health Questionnaire was used to diagnose depression, and automated diagnostic, pharmacy, and laboratory data were used to measure diabetes treatment intensity, HbA 1c levels, and diabetes complications.RESULTS -Independent factors that were associated with a significantly higher likelihood of meeting criteria for major depression included younger age, female sex, less education, being unmarried, BMI Ն30 kg/m 2 , smoking, higher nondiabetic medical comorbidity, higher numbers of diabetes complications in men, treatment with insulin, and higher HbA 1c levels in patients Ͻ65 years of age. Independent factors associated with a significantly higher likelihood of meeting criteria for minor depression included younger age, less education, non-Caucasian status, BMI Ն30 kg/m 2 , smoking, longer duration of diabetes, and a higher number of complications in older (Ն65 years) patients.CONCLUSIONS -Smoking and obesity were associated with a higher likelihood of meeting criteria for major and minor depression. Diabetes complications and elevated HbA 1c were associated with major depression among demographic subgroups: complications among men and HbA 1c among individuals Ͻ65 years of age. Older patients with a higher number of complications had an increased likelihood of minor depression. Diabetes Care 27:914 -920, 2004A recent meta-analysis of 39 studies in patients with diabetes reported an estimate of major depression in 11% of patients based on structured psychiatric interviews and elevated depression symptoms in 31% based on depression-rating scales (1). Prior research on sociodemographic predictors of depression in patients with diabetes has shown high risk for female sex (2-4), younger age (2-4), less education (2-6), and less income (1,3,4,7). Depression has also been found in two recent metaanalyses to have significant associations with increased HbA 1c levels (8) and diabetes complications (9). Most of the studies included in these meta-analyses had small, nonrepresentative samples and did not fully characterize the depressed versus the nondepressed patients in terms of the number of complications, type of diabetes, insulin dependence, behavioral risk factors (i.e., smoking, obesity), medical comorbidity, socioeconomic variables, race, or ethnicity (1,8,9). The lack of reporting of sociodemographic and clinical variables in most studies is a significant limitation, as analyses of the association between depression and diabetes severity and HbA 1c have often not controlled for potentially important confounding variables (1,8,9).The small sample sizes also precluded the study of potentially important interactions such as the effect of age and sex on ...

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Depression and the Dynamics of Smoking

Cited by 714 publications

References 28 publications

Depressão e síndromes isquêmicas miocárdicas instáveis: diferenças entre homens e mulheres

Depressão e síndromes isquêmicas miocárdicas instáveis: diferenças entre homens e mulheres

Major life event – diagnosis of schizophrenia in offspring and risk for cancer

Behavioral and Clinical Factors Associated With Depression Among Individuals With Diabetes

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