Abstract
ObjectiveTo investigate the risk factors that contribute to smoking in female patients with major depressive disorder (MDD) and the clinical features in depressed smokers.MethodsWe 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.ResultsAmong 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.ConclusionsAlthough 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.
Highlights
Smoking remains the single most important and preventable cause of premature female death in some developed countries [1]
The main aim of our research is to investigate in a large sample of Chinese women with recurrent major depressive disorder (MDD): (i) the differences in clinical features between depressed smokers and depressed nonsmokers; (ii) the risk factors that contribute to smoking in female patients with MDD
We looked at the association between clinical features and smoking to determine if they distinguish between lifetime smokers and never smokers
Summary
Smoking remains the single most important and preventable cause of premature female death in some developed countries (such as the USA, the UK) [1]. Culture and lower socioeconomic status are the main factors that explain why women smoke less than men. While these factors protect women from smoking, as their influence wanes, the rates of female smoking are likely to increase [3]. The main diseases caused by smoking are cancers (especially lung cancer), heart disease and chronic bronchitis These smoking related diseases affect both sexes smoking causes specific impairments to women: (i) for women taking oral contraception the risk of both heart disease and stroke increases substantially; (ii) the risk of cervical cancer increases two fold; (iii) there are adverse affects on the female reproductive system, including dysmenorrhea, decreased fertility and early menopause [4]
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