Comorbidity, smoking behavior and treatment outcome

Nancy J. Keuthen, Raymond Niaura, Belinda Borrelli, Michael Goldstein, Judith DePue, Chris Murphy, David Gastfriend, Stewart R. Reiter, David Abrams

Research output: Contribution to journalArticle

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. Copyright (C) 2000 S. Karger AG, Basel.

Original languageEnglish (US)
Pages (from-to)244-250
Number of pages7
JournalPsychotherapy and Psychosomatics
Volume69
Issue number5
StatePublished - Sep 2000

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Comorbidity
Smoking
Psychiatry
Depression
Self Report
Substance-Related Disorders
Therapeutics
Anxiety
Equipment and Supplies
Tobacco Use Disorder
Fluoxetine
Smoking Cessation
Mental Disorders
Smoke
Tobacco Products
Diagnostic and Statistical Manual of Mental Disorders
Interviews
Population

Keywords

  • Comorbidity
  • Nicotine dependence
  • Smoking cessation

ASJC Scopus subject areas

  • Psychology(all)

Cite this

Keuthen, N. J., Niaura, R., Borrelli, B., Goldstein, M., DePue, J., Murphy, C., ... Abrams, D. (2000). Comorbidity, smoking behavior and treatment outcome. Psychotherapy and Psychosomatics, 69(5), 244-250.

Comorbidity, smoking behavior and treatment outcome. / Keuthen, Nancy J.; Niaura, Raymond; Borrelli, Belinda; Goldstein, Michael; DePue, Judith; Murphy, Chris; Gastfriend, David; Reiter, Stewart R.; Abrams, David.

In: Psychotherapy and Psychosomatics, Vol. 69, No. 5, 09.2000, p. 244-250.

Research output: Contribution to journalArticle

Keuthen, NJ, Niaura, R, Borrelli, B, Goldstein, M, DePue, J, Murphy, C, Gastfriend, D, Reiter, SR & Abrams, D 2000, 'Comorbidity, smoking behavior and treatment outcome', Psychotherapy and Psychosomatics, vol. 69, no. 5, pp. 244-250.
Keuthen NJ, Niaura R, Borrelli B, Goldstein M, DePue J, Murphy C et al. Comorbidity, smoking behavior and treatment outcome. Psychotherapy and Psychosomatics. 2000 Sep;69(5):244-250.
Keuthen, Nancy J. ; Niaura, Raymond ; Borrelli, Belinda ; Goldstein, Michael ; DePue, Judith ; Murphy, Chris ; Gastfriend, David ; Reiter, Stewart R. ; Abrams, David. / Comorbidity, smoking behavior and treatment outcome. In: Psychotherapy and Psychosomatics. 2000 ; Vol. 69, No. 5. pp. 244-250.
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