Nicotine dependence and psychiatric and substance use comorbidities in a sample of American Indian male veterans

Abstract

Substantial co-morbidity exists between nicotine dependence and other substance abuse and psychiatric disorders among this sample of American Indian male veterans, particularly for lifetime diagnoses. Screening for all psychiatric disorders among American Indian/Alaska Native smokers may be warranted. Although these results are similar to those observed among the general U.S. population, unique risk factors exist among American Indians/Alaska Natives which may require further attention. Specific public health and clinical interventions to reduce the rate of nicotine dependence among American Indians/Alaska Natives are recommended.

Nicotine dependence and psychiatric and substance use disorder comorbidities among American Indians/Alaska Natives: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions

“…The odds ratios from our current sample far exceeded those from the Dickerson et al (2009) study for any drug use disorder and the antisocial personality disorder subcategory (5.38 and 5.30 vs. 2.84 and 3.19, respectively). However, the odds ratios from our sample were lower than the previous study for mood/affective and anxiety disorders (3.26 and 2.54 vs. 6.65 and 3.93, respectively).…”

“…In the generalpopulation, the rate of comorbidity between pathological gambling and nicotine dependence has been cited as high as 60% (Petry et al, 2005), and in our previous study, the comorbidity rate was 17%, with pathological gambling being significantly associated with nicotine dependence (Dickerson et al, 2009). In our study, however, the association between lifetime nicotine dependence and pathological gambling was not captured, most likely due to low power.…”

“…To our knowledge, the only study analyzing both psychiatric and substance use comorbidities among AI/ANs with nicotine dependence is a study conducted by our group among a sample of AI/AN male veterans (Dickerson et al, 2009). In that study, the association of both lifetime and 12-month nicotine dependence with both lifetime and 12-month psychiatric and substance abuse disorders, respectively, was analyzed.…”

“…This study seeks to analyze lifetime nicotine dependence (recreational tobacco use; all forms of tobacco) with both psychiatric and substance use disorder comorbidities utilizing similar methodologies from our groups' prior study conducted among AI/AN male veterans (Dickerson et al, 2009) but with a more representative AI/AN sample which also includes females. In addition to analyzing these comorbidities, we also seek to examine the differences in comorbidities between AI/AN males and females.…”

Negative Affective States and Cognitive Impairments in Nicotine Dependence

“…Nicotine addiction and dependence has a much higher prevalence in individuals with a psychiatric diagnosis and is associated with higher levels of smoking compared to psychiatrically healthy individuals (Lawrence et al, 2009). This relationship has been noted for numerous psychiatric disorders, including schizophrenia (de Leon et al, 1995), attention deficit hyperactivity disorder (ADHD) (Chen et al, 2012;McClernon and Kollins, 2008;Pomerleau et al, 1995), major depression (Breslau et al, 1991;Chen et al, 2012;Glassman et al, 1988), bipolar disorder (Waxmonsky et al, 2005), anxiety disorders (Breslau et al, 1991;Chen et al, 2012;Dickerson et al, 2009), post-traumatic stress disorder (PTSD) (Beckham et al, 1995;Chen et al, 2012;Dickerson et al, 2009;Koenen et al, 2005;Roberts et al, 2008), antisocial personality disorder (Chen et al, 2012;Dickerson et al, 2009), and obsessive-compulsive disorder (Grabe et al, 2001), as well as addiction to other substances (Chen et al, 2012;Dickerson et al, 2009;Grabe et al, 2001). These associations could be interpreted as support for the premise that psychological and neurobiological attributes that predispose individuals to nicotine addiction also predispose them to these other disorders .…”