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Vol. 69, No. 5, 2000
Issue release date: September–October 2000
Section title: Regular Article
Psychother Psychosom 2000;69:244–250
(DOI:10.1159/000012403)

Comorbidity, Smoking Behavior and Treatment Outcome

Keuthen N.J. · Niaura R.S. · Borrelli B. · Goldstein M. · DePue J. · Murphy C. · Gastfriend D. · Reiter S.R. · Abrams D.
aDepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass.; bDivision of Behavioral and Preventive Medicine, Miriam Hospital and Brown University Medical School, Providence, R.I., USA

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Article / Publication Details

First-Page Preview
Abstract of Regular Article

Published online: 8/17/2000

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 1

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS

Abstract

Background: A sizeable sector of the population continues to smoke cigarettes despite our efforts to prevent and treat this addiction. We explored the relationships between lifetime comorbidity, psychiatric symptomatology, smoking behavior and treatment outcome to better understand vulnerability to smoking and treatment response. Methods: One hundred and twenty smokers at two sites were enrolled in a multicenter, double-blind, randomized, 10-week smoking cessation trial with fluoxetine and behavioral treatment. The Structured Clinical Interview for DSM-III-R and Hamilton Depression Rating Scale were administered prior to treatment initiation. Self-report measures were used to assess psychiatric symptoms throughout treatment and during a 6-month follow-up period. Results: Overall 62.3% of our sample were diagnosed with a lifetime mood, anxiety or substance use disorder despite stringent study exclusion criteria. Lifetime comorbidity was shown to be related to higher smoking rates and nicotine dependence, depressed mood and greater self-report of anxiety and stress. Lifetime comorbidity, however, alone or in combination with treatment condition, failed to predict treatment outcome (at posttreatment or follow-up). Baseline depression scores (Beck Depression Inventory, BDI) were related to treatment outcome only for smokers without a positive history of any psychiatric disorder or depression, with lower BDI scores more frequent in those who were abstinent. Conclusions: High prevalence rates of lifetime psychiatric illness and substance use disorders are reported for chronic smokers. Subsyndromal psychiatric symptoms may play a role in smoking behavior in combination with diagnosable disorders. Clinicians need to carefully assess both psychiatric diagnoses and symptoms in chronic smokers to optimize patient-treatment matching.


  

Author Contacts

Nancy J. Keuthen, PhD
Massachusetts General Hospital-East, 149 13th Street, 9th Floor
Charlestown, MA 02129 (USA)
Tel. +1 617 726 4074, Fax +1 617 726 4078E-Mail keuthen@psych.mgh.harvard.edu

  

Article Information

Number of Print Pages : 7
Number of Figures : 0, Number of Tables : 1, Number of References : 38

  

Publication Details

Psychotherapy and Psychosomatics
Founded 1953 as ‘Acta Psychotherapeutica et Psychosomatica’ by E.A.D.E. Carp and B. Stokvis, continued by Th. Spoerri (1964–1974) and P.E. Sifneos (1974–1991)

Vol. 69, No. 5, Year 2000 (Cover Date: September-October 2000)

Journal Editor: G.A. Fava, Bologna
ISSN: 0033–3190 (print), 1423–0348 (Online)

For additional information: http://www.karger.com/journals/pps


Article / Publication Details

First-Page Preview
Abstract of Regular Article

Published online: 8/17/2000

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 1

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS


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