Relationship of Mood Disturbance to Cigarette Smoking Status Among 252 Patients With a Current Mood Disorder
J Clin Psychiatry 2001;62:319-324
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The relationship between cigarette
smoking and mood has received increasing attention. This
retrospective study evaluated the relationship between mood
disturbance and cigarette smoking status among patients with a
current mood disorder. The association between level of nicotine
dependence and severity of mood disturbance was also evaluated
among current smokers.
Method: Retrospective data for 252 patients
(63.5% male, 85.0% white) admitted for treatment of a mood
disorder at the San Diego Veteran Affairs Mental Health Clinical
Research Center between November 1988 and June 1997 were studied.
All current cigarette smokers at admission (N = 126) were matched
with nonsmokers (N = 126) on the primary DSM-IV Axis I mood
disorder diagnosis, admission status (inpatient or outpatient),
gender, age (± 5 years), and ethnicity. The Hamilton Rating
Scale for Depression (HAM-D), the Beck Depression Inventory, and
the Profile of Mood States (POMS) were administered to patients
on admission. Conditional logistic regression analysis for
matched sets with a backward elimination was used to identify
factors independently predictive of current smoking status.
Results: A greater number of cups of coffee
consumed per day (p = .002), a history of alcoholism (p = .004),
and higher POMS fatigue subscale scores (p = .007) were
predictive of current smoking status. Among current smokers, the
HAM-D terminal insomnia item was positively associated with mean
number of cigarettes smoked per day (p = .012).
Conclusion: Cigarette smoking should be
addressed in the treatment of patients with a current mood
disorder. Smokers experience greater levels of fatigue than
nonsmokers. In addition, higher cigarette consumption levels are
associated with mild-to-severe symptoms of terminal insomnia.