Relationship of tobacco use to depressive disorders and suicidality among patients treated for alcohol dependence.

Nicotine Research Center, Mayo Clinic and Mayo Foundation, Rochester, Minn 55905, USA.
American Journal on Addictions (Impact Factor: 1.74). 07/2009; 12(1):71-83. DOI: 10.1080/10550490390143385
Source: PubMed

ABSTRACT This population-based, retrospective cohort study examined the association of tobacco use and diagnosis of a depressive disorder (DD) and suicide attempts (SA) before and after discharge from an inpatient addiction program (IAP). All 813 Olmsted County, Minnesota residents (537 males, 276 females) admitted for the first time to the IAP for treatment of alcoholism during the period 1972-1983 were studied. Tobacco use status at admission was classified as ever (current or former use) (85.5%), never (8.6%), or missing (5.9%). Subjects were followed through 1994. Current or former use of tobacco was markedly lower among those with a prior diagnosis of DD than those without this diagnosis (73.6% vs. 89.3%, p<0.001). Although females were more likely to have a diagnosis of DD and were less likely to have ever used tobacco than males, gender did not explain the relationship between tobacco use and DD. Tobacco use status was unrelated to a DD diagnosis after discharge from the IAP and was not associated with SA.

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    • "Age, gender, alcohol abuse/ dependence, and affective illness are a few of the identified risk factors for suicidal ideation, suicide attempts and suicide (Bhopal 1992; Sheikh 2000; Crosby et al., 2002; Makikyro et al., 2004; Wu et al., 2004; Kessler et al., 2005; McGee et al., 2005; Sareen et al., 2005; Bromet et al., 2007; Kessler et al., 2007; Oquendo et al., 2007; Bronisch et al., 2008) and also appear to be correlated with smoking (Bhopal 1992; Angst et al., 1998; Anthony et al., 2000; Sheikh 2000; Tanskanen et al., 2000a; Patten et al., 2003; Makikyro et al., 2004; Schumann et al., 2004; Breslau et al., 2005; Iwaski et al., 2005; Kessler et al.,2005; McGee et al., 2005; Sareen et al., 2005; Falk et al., 2006; Kessler et al., 2007; Oquendo et al., 2007; Riala et al., 2007b; Bronish et al., 2008). Individuals who suffer from mental health conditions, such as depressive disorders, anxiety symptoms, or alcohol abuse/dependence are at a significantly greater risk of experiencing suicidal ideation, attempting suicide and dying by suicide compared to those without these disorders (Robins et al., 1959; Coombs et al., 1992; Schaffer 1993; Sheikh 2000; Crosby et al., 2002; Breslau et al., 2005; De Leo et al., 2005; McGee et al,. "
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    ABSTRACT: The incidence rate of suicidal ideation among current and former smokers versus never smokers is not known. In this study, the age-adjusted incidence of suicidal ideation was highest among current smokers, followed by former, then never smokers. The adjusted hazard for suicide ideation was 2.22 (95%CI = 1.48, 3.33) and 1.19 (95%CI = 0.78, 1.82) for current and former smokers, respectively, compared to never smokers. Results indicate that current smokers have increased risks of suicidal ideation above and beyond the risk for never and former smokers regardless of age, gender, history of depressive disorder or anxiety symptoms, and alcohol abuse/dependence. Smoking cessation might be beneficial for some suicide prevention efforts.
    Suicide and Life-Threatening Behavior 08/2010; 40(4):307-18. DOI:10.1521/suli.2010.40.4.307 · 1.40 Impact Factor
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    • "Fifth, there could be also an interaction between different risk factors predisposing to suicidality. Mental disorders such as depression and addiction, promote smoking which in turn leads to suicidality (Breslau et al., 2004b; Sher et al., 2005; Patten et al., 2003). In a clinical prospective study Oquendo et al. (2004) found to be the most powerful predictive factors of future suicide attempts the subjective rating of the severity of depression, as well as cigarette smoking, each of which was associated with future risk of suicidality in patients with major depressive disorder or bipolar disorder. "
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    ABSTRACT: The temporal relationship between smoking and suicidality is not yet clear. This article examines associations between smoking and suicidality and their temporal ordering of onset. Baseline and four-year follow-up data were used from the Early Developmental Stages of Psychopathology (EDSP) study, a prospective longitudinal study of adolescents and young adults in Munich, Germany. We assessed smoking (occasional and regular), nicotine dependence, suicidal ideation and suicide attempts using the standardized Munich-Composite International Diagnostic Interview (M-CIDI). Suicide ideation and suicide attempts were strongly associated with occasional and regular smoking and nicotine dependence at baseline (Odds ratios [OR] range from 1.4 to 16.4). In the prospective analyses, prior occasional, regular smoking and nicotine dependence increased the risk for new onset of suicide ideation (OR range from 1.5 to 2.7) and prior regular smoking and nicotine dependence increased also the risk for onset of suicide attempt(s) (OR range between 3.1 and 4.5). Pre-existing suicidality could not be shown to be associated with subsequent smoking or nicotine dependence. Associations remained stable when participants who fulfilled DSM-IV-criteria for major depression were excluded. The sample is confined to an age cohort of 14 to 24 years. No completed suicides could be observed. The presence of associations between prior smoking and subsequent suicidality, in concert with the lack of associations between prior suicidality and subsequent smoking suggests the existence of an independent pathway from smoking to suicidality.
    Journal of Affective Disorders 06/2008; 108(1-2):135-45. DOI:10.1016/j.jad.2007.10.010 · 3.71 Impact Factor
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    ABSTRACT: There is significant psychiatric literature indicating that smoking is associated with all forms of suicidality, including suicide ideation. The goal of this study was to determine if smoking is associated with suicide ideation in chronic low back pain (CLBP) patients. CLBP patients identified themselves as either current smokers (N = 81) or nonsmokers (N = 140) and completed a number of evaluation instruments, which included the Beck Depression Inventory (BDI) and the Coping Strategies Questionnaire (CSQ). BDI question number 9 was utilized to define CLBP with suicide ideation and subsequently, in addition, items number 3 and number 6 from the CSQ were added to the BDI item number 9 in order to fully capture CLBP with suicide ideation. Utilizing this expanded definition of suicide ideation (BDI plus CSQ), CLBP smokers were compared with CLBP nonsmokers for the frequency of suicide ideation. Regression analysis was utilized to investigate the CLBP smoking suicide ideation group. Finally, we investigated whether heavy use of alcohol and coffee impacted on CLBP heavy smokers in terms of increasing suicide ideation risk. CLBP patients were recruited from a pain facility. CLBP smokers were more likely to complain of suicide ideation, and this relationship correlated with the number of cigarettes smoked per day. Seventy-eight percent of the CLBP smokers were classified correctly in terms of the presence of suicide ideation by three variables: diagnosis of major depression, Function Assessment Questionnaire total score, and BDI total score. The relative risk of suicide ideation was increased by combining heavy smoking (greater than one pack per day) with heavy alcohol use. CLBP smokers appear to be at greater risk for suicide ideation than nonsmoking CLBP patients. The risk of suicide ideation is even greater if the CLBP patient is a heavy smoker and has problems with alcohol.
    Pain Medicine 04/2009; 10(2):340-6. DOI:10.1111/j.1526-4637.2009.00570.x · 2.24 Impact Factor
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