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January 1993

Nicotine Dependence and Major DepressionNew Evidence From a Prospective Investigation

Author Affiliations

From the Departments of Biostatistics and Research Epidemiology and Psychiatry, Henry Ford Hospital, Detroit, Mich, and the University of Michigan School of Medicine, Ann Arbor (Dr Breslau); the Department of Psychology, Wayne State University, Detroit (Dr Kilbey); and the Department of Psychiatry, Henry Ford Hospital (Ms Andreski).

Arch Gen Psychiatry. 1993;50(1):31-35. doi:10.1001/archpsyc.1993.01820130033006

• We examined prospectively the association between nicotine dependence and major depression (MDD). The following questions were addressed: (1) Are smokers with a history of MDD at increased risk for progression to nicotine dependence and more severe levels of dependence? (2) Are persons with a history of nicotine dependence at increased risk for MDD? A sample of 995 young adults were interviewed in 1989 and reinterviewed in 1990, 14 months later. The revised National Institute of Mental Health— Diagnostic Interview Schedule was used to ascertain DSM-III-R nicotine dependence and other substance use and psychiatric disorders. A history of MDD increased the risk for progression to nicotine dependence or more severe levels of dependence (odds ratio, 2.06; 95% confidence interval, 1.21 to 3.49). In addition, persons with a history of nicotine dependence had a higher rate of first-incidence MDD during the follow-up period than persons with no history of nicotine dependence (7.5% vs 3.2%; odds ratio, 2.45; 95% confidence interval, 1.17 to 5.15). The prospective data suggest that the association between nicotine dependence and MDD, observed previously in cross-sectional studies, might be either causal, with influences flowing in both directions, or, more probably, noncausal, reflecting the effects nf common factors that predispose to both disorders.