Get access

DEPRESSION AND SMOKING: A 5-YEAR PROSPECTIVE STUDY OF PATIENTS WITH MAJOR DEPRESSIVE DISORDER

Authors

  • Irina A. K. Holma M.D.,

    1. Mood, Depression, and Suicidal Behaviour Unit, National Institute for Health and Welfare, Helsinki, Finland
    2. Department of Psychiatry, Helsinki University Central Hospital (HUCH), Helsinki, Finland
    Search for more papers by this author
  • K. Mikael Holma M.D., Ph.D.,

    1. Mood, Depression, and Suicidal Behaviour Unit, National Institute for Health and Welfare, Helsinki, Finland
    Search for more papers by this author
  • Tarja K. Melartin M.D., Ph.D.,

    1. Mood, Depression, and Suicidal Behaviour Unit, National Institute for Health and Welfare, Helsinki, Finland
    2. Department of Psychiatry, Helsinki University Central Hospital (HUCH), Helsinki, Finland
    Search for more papers by this author
  • Mikko Ketokivi Ph.D.,

    1. Operations and Technology Department, IE Business School, Madrid, Spain
    Search for more papers by this author
  • Erkki T. Isometsä M.D., Ph.D.

    Corresponding author
    1. Department of Psychiatry, Helsinki University Central Hospital (HUCH), Helsinki, Finland
    2. Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland
    • Mood, Depression, and Suicidal Behaviour Unit, National Institute for Health and Welfare, Helsinki, Finland
    Search for more papers by this author

  • Contract grant sponsor: University of Helsinki.

Correspondence to: Erkki T. Isometsä, M.D., Ph.D., Professor of Psychiatry, Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki, P.O. Box 22 (Välskärinkatu 12 A), Helsinki 00014, Finland. E-mail: erkki.isometsa@hus.fi

Abstract

Background

Major depressive disorder (MDD) and smoking are major public health problems and epidemiologically strongly associated. However, the relationship between smoking and depression and whether this is influenced by common confounding factors remain unclear, in part due to limited longitudinal data on covariation.

Methods

In the Vantaa Depression Study, psychiatric out- and inpatients with DSM-IV MDD and aged 20–59 years at were followed from baseline to 6 months, 18 months, and 5 years. We investigated course of depression, smoking, and comorbid alcohol-use disorders among the 214 patients (79.6% of 269) participating at least three time points; differences between smoking versus nonsmoking patients, and covariation of MDD, smoking, and alcohol-use disorders.

Results

Overall, 31.3% of the patients smoked regularly, 41.1% intermittently, and 27.6% never. Smokers were younger, had more alcohol-use disorders and Cluster B and C personality disorder symptoms, a higher frequency of lifetime suicide attempts, higher neuroticism, smaller social networks, and lower perceived social support than never smokers. Smoking and depression had limited longitudinal covariation. Depression, smoking, and alcohol-use disorders all exhibited strong autoregressive tendencies.

Conclusions

Among adult psychiatric MDD patients, smoking is strongly associated with substance-use and personality disorders, which may confound research on the impact of smoking. Rather than depression or smoking covarying or predicting each other, depression, smoking, and alcohol-use disorders each have strong autoregressive tendencies. These findings are more consistent with common factors causing their association than either of the conditions strongly predisposing to the other.

Get access to the full text of this article

Ancillary