Journal of Addiction Research & Therapy
Open Access

Abstract

Background: Patients with co-occurring mood disorders either major depressive disorders or bipolar disorders and tobacco use disorder have more severe depressive and anxiety symptoms and recover more slowly and smoking worsens treatment prognosis. Objectives: The aim was to evaluate gender and depressive smokersâ�� differences in clinical characteristics and smoking cessation. Methods: In this study, 211 smokers, 135 women and 76 men, 101 depressed smokers and 110 non-depressed smokers were recruited from the Center of Approach and Treatment for Smokers for a period of 52 weeks. Smokers were submitted to a smoking cessation treatment consisted of pharmacotherapy combined with cognitive therapy. Smoking cessation was assessed by exhaled carbon monoxide. The diagnoses of tobacco use disorder and mood disorders were performed by structured clinical interview, clinical version (SCID-I) based on the DSM-IV. Participants underwent a structured interview to assess the sociodemographic, clinical, family and smoking history. The Fagerstrom Test for Nicotine Dependence (FTND), Hamilton Depression Rating Scale (HDRS) and the Alcohol Smoking and Substance Involvement Screening Test (ASSIST) were used. The body mass index (BMI) was evaluated. Laboratory measures were serum glucose, total cholesterol, high-density cholesterol (HDL-C), lowdensity cholesterol, triglycerides and tumor necrosis factor alpha (TNF-�±), interleukin-6 (IL-6) and C-reactive protein (CRP). Results: Depressed men smokers used more cigarettes daily, presented more alcohol consumption, lower levels of HDL-C, higher levels of triglycerides and TNF-�± than depressed and non-depressed women smokers n (p<0.05). However, depressed and non- depressed women were more worried about weight gain and presented lower body mass index (BMI-Kg/m) than men. Depressed smokers have higher levels of pro-inflammatory cytokines (PICs) than non-depressed smokers including TNF-�±, IL-6 and acute phase proteins such as CRP compared to non-depressed smokers. Depressive smokers were found to exhibit more severe symptoms than depressed non-smokers on the Hamilton depression rating scale as well as exhibiting more anxiety, a higher risk of alcohol consumption and more suicide attempts than non-depressed smokers. The same smoking cessation treatment was effective for both genders and depressed and non-depressed smokers. Conclusion: The differences in clinical characteristics suggested possible benefits from interventions that are targeted to a specific gender. Patients with co-occurring mood disorders and tobacco use disorder in clinical practice are common; therefore, clinicians may have to treat these patients as having co-occurring disorders.

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