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Pollard J, Reardon T, Williams C, Creswell C, Ford T, Gray A, Roberts N, Stallard P, Ukoumunne OC, Violato M. The multifaceted consequences and economic costs of child anxiety problems: A systematic review and meta-analysis. JCPP ADVANCES 2023; 3:e12149. [PMID: 37720587 PMCID: PMC10501703 DOI: 10.1002/jcv2.12149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/26/2023] [Indexed: 09/19/2023] Open
Abstract
Background Over a quarter of people have an anxiety disorder at some point in their life, with many first experiencing difficulties during childhood or adolescence. Despite this, gaps still exist in the current evidence base of the multiple consequences of childhood anxiety problems and their costs. Methods A systematic review of Medline, PsycINFO, EconLit and the National Health Service Economic Evaluation Database was conducted for longitudinal and economic studies reporting on the association between childhood anxiety problems and at least one individual-, family- or societal-level outcome or cost. All studies were synthesised narratively. For longitudinal studies, 'effect direction' was used as a common metric, with random effects meta-analysis undertaken where possible. Results Eighty-three studies met inclusion criteria and were synthesised narratively. We identified 788 separate analyses from the longitudinal studies, which we grouped into 15 overarching outcome domains. Thirteen of the studies were incorporated into 13 meta-analyses, which indicated that childhood anxiety disorders were associated with future anxiety, mood, behaviour and substance disorders. Narrative synthesis also suggested associations between anxiety problems and worse physical health, behaviour, self-harm, eating, relationship, educational, health care, employment, and financial outcomes. 'Effect direction' was conflicting in some domains due to a sparse evidence base. Higher economic costs were identified for the child, their families, healthcare providers and wider society, although evidence was limited and only covered short follow-up periods, up to a maximum of 2 years. Total annual societal costs per anxious child were up to £4040 (2021 GBP). Conclusions Childhood anxiety problems are associated with impaired outcomes in numerous domains, and considerable economic costs, which highlight the need for cost-effective interventions and policies to tackle them. More economic evidence is needed to inform models of the long-term, economic-related, consequences of childhood anxiety problems.
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Affiliation(s)
- Jack Pollard
- Health Economics Research CentreNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Tessa Reardon
- Departments of Experimental Psychology and PsychiatryUniversity of OxfordOxfordUK
| | - Chloe Williams
- Departments of Experimental Psychology and PsychiatryUniversity of OxfordOxfordUK
| | - Cathy Creswell
- Departments of Experimental Psychology and PsychiatryUniversity of OxfordOxfordUK
| | - Tamsin Ford
- University of Cambridge and Cambridge and Peterborough Foundation TrustCambridgeUK
| | - Alastair Gray
- Health Economics Research CentreNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Nia Roberts
- Bodleian Health Care LibrariesUniversity of OxfordOxfordUK
| | | | - Obioha C. Ukoumunne
- NIHR Applied Research Collaboration South West Peninsula (PenARC)University of ExeterExeterUK
| | - Mara Violato
- Health Economics Research CentreNuffield Department of Population HealthUniversity of OxfordOxfordUK
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Stevenson J, Miller CL, Martin K, Mohammadi L, Lawn S. Investigating the reciprocal temporal relationships between tobacco consumption and psychological disorders for youth: an international review. BMJ Open 2022; 12:e055499. [PMID: 35697442 PMCID: PMC9196180 DOI: 10.1136/bmjopen-2021-055499] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate reciprocal temporal relationships between tobacco consumption and psychological disorders for youth.Design: Review DATA SOURCES: Five databases (PubMed, Embase, Scopus, CINAHL and PsycINFO) on 26 September 2019 and updated on 11 May 2021, indexing tobacco, mental illness and longitudinal.Study selection: Methods used consensus and multiple reviewers. INTERVENTIONS Cohort studies (n=49) examining tobacco and selected psychological disorders (depression, anxiety, bipolar, psychosis, borderline personality disorder) among youth, and systematic reviews (n=4) of these relationships met inclusion criteria. PRIMARY AND SECONDARY OUTCOME MEASURES Effect of tobacco on psychological disorders and effect of psychological disorders on tobacco. DATA EXTRACTION AND SYNTHESIS Independent extraction by the first author and checked by final author. Joanna Briggs Institute Critical Appraisal Tools were used for all studies.Included studies had moderate-to-high appraisal scores. We synthesised findings using vote counting for effect direction and descriptive data. RESULTS Fifty-three studies were included in the review. Thirteen of 15 studies showed a positive effect direction of tobacco on depression (p<0.001). Six of 12 studies showed a positive effect direction of depression on tobacco (p=0.016). Six of eight studies showed a positive effect direction of tobacco on anxiety (p=0.016). Eleven of 18 studies showed a positive effect direction of anxiety on tobacco (p=0.003). No effect between tobacco and bipolar, or tobacco and psychosis was found. No studies examined tobacco and borderline personality disorder. CONCLUSIONS Reciprocal relationships existed between tobacco and both depression and anxiety for youth, though causality is unconfirmed. No positive effect direction was found between tobacco and psychosis, perhaps because nicotine has conflicting effects on psychosis. For other relationships examined, evidence was weak because of low number of studies. More research to inform prevention and early intervention is needed. PROSPERO REGISTRATION NUMBER CRD42020150457.
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Affiliation(s)
- Jeremy Stevenson
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Caroline Louise Miller
- Public Health, The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Kimberley Martin
- Public Health, The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia
| | - Leila Mohammadi
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Sharon Lawn
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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Brunette MF, Ferron JC, Aschbrenner KA, Pratt SI, Geiger P, Kosydar S. Attitudes about smoking cessation treatment, intention to quit, and cessation treatment utilization among young adult smokers with severe mental illnesses. Addict Behav 2019; 89:248-255. [PMID: 30343187 PMCID: PMC6368265 DOI: 10.1016/j.addbeh.2018.09.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 09/16/2018] [Accepted: 09/24/2018] [Indexed: 11/22/2022]
Abstract
SIGNIFICANCE Young adults with schizophrenia, bipolar disorder and other severe mental illnesses (SMI) have high rates of smoking, but little research has evaluated predictors of cessation activity and treatment utilization in this group. METHODS We assessed attitudes, beliefs, social norms, perceived behavioral control, intention, quit attempts, treatment utilization, and cessation among 58 smokers with SMI, age 18-30, enrolled in a randomized pilot study comparing a brief interactive/motivational vs. a static/educational computerized intervention. Subjects were assessed at baseline, post intervention, and 3-month follow-up. RESULTS Over follow-up, one-third of participants self-reported quit attempts. Baseline measures indicating lower breath CO, greater intention to quit, higher perceptions of stigma, higher perceptions of psychological benefits of smoking, and greater symptom distress were associated with quit attempts, whereas gender, diagnosis, social support, attitudes about smoking, and use of cessation treatment were not. In the multivariate analysis, lower breath CO, higher intention to quit and symptom distress were significantly related to quit attempts. Only 5% of participants utilized verified cessation treatment during follow-up. Consistent with the Theory of Planned Behavior, attitudes, social norms and perceived behavioral control regarding cessation treatments correlated significantly with intention to use treatment. Norms and beliefs about treatment were somewhat positive and some improved after intervention, with a pattern significantly favoring the interactive intervention, but intentions to use treatments remained low, consistent with low treatment utilization. CONCLUSIONS Perceptions of traditional cessation treatments improved somewhat after brief interventions, but most young adult smokers with SMI did not use cessation treatment. Instead, interventions led to quit attempts without treatment.
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Affiliation(s)
- Mary F Brunette
- Dartmouth-Hitchcock, United states; Geisel School of Medicine at Dartmouth, United states.
| | - Joelle C Ferron
- Dartmouth-Hitchcock, United states; Geisel School of Medicine at Dartmouth, United states
| | - Kelly A Aschbrenner
- Dartmouth-Hitchcock, United states; Geisel School of Medicine at Dartmouth, United states
| | - Sarah I Pratt
- Dartmouth-Hitchcock, United states; Geisel School of Medicine at Dartmouth, United states
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4
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Brunette MF, Ferron JC, Robinson D, Coletti D, Geiger P, Devitt T, Klodnick V, Gottlieb J, Xie H, Greene MA, Ziedonis D, Drake RE, McHugo GJ. Brief Web-Based Interventions for Young Adult Smokers With Severe Mental Illnesses: A Randomized, Controlled Pilot Study. Nicotine Tob Res 2018; 20:1206-1214. [PMID: 29059417 PMCID: PMC6121912 DOI: 10.1093/ntr/ntx190] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 08/22/2017] [Indexed: 11/14/2022]
Abstract
Significance About 50% of young adults with schizophrenia, bipolar disorder, and other severe mental illnesses smoke tobacco, but few studies have evaluated interventions for this group. Methods We conducted a randomized pilot study among 58 young adult smokers with severe mental illnesses comparing a brief interactive web-based motivational tool, Let's Talk About Smoking, to computerized standard education from the National Cancer Institute. An additional 23 subjects received minimal tobacco assessment at baseline and no intervention, providing a comparison condition for naturalistic cessation behavior. All participants (total n = 81) were assessed for smoking and breath carbon monoxide at baseline and 14 weeks and had access to standard cessation treatments. Results The 81 participants were stable outpatients ages 18-30 (mean 24.8 years): 43.2% were diagnosed with schizophrenia-spectrum disorders, the remainder with severe mood and anxiety disorders. They smoked 14.6 ± 10.2 cigarettes per day. All participants completed their assigned intervention; 83.4% of Let's Talk About Smoking users and 71.4% of standard education users rated their intervention "good" or "very good." At 14 weeks, less than 15% of participants in all conditions had used additional cessation treatment. Let's Talk About Smoking users were more likely to have biologically verified abstinence at 14 weeks than standard education users (14.8% vs. 0%; X2 = 3.7, p = .05). None of the participants in the naturalistic comparison condition were abstinent at 14 weeks. Conclusions Interactive, web-based motivational interventions are feasible and promising for smoking cessation among young smokers with severe mental illnesses. Such interventions warrant further study among this group of smokers. Implications Young adult smokers with severe mental illnesses are a vulnerable population that, without intervention, goes on to experience disparate morbidity and mortality. Brief, easily disseminable interventions are needed to facilitate cessation in this group. This pilot research indicates that brief, technology-delivered, motivational interventions that are tailored for this group may be able to activate a significant number to quit without additional cessation intervention.
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Affiliation(s)
- Mary F Brunette
- Geisel School of Medicine at Dartmouth, and Department of Psychiatry, Dartmouth-Hitchcock, Lebanon, NH
| | - Joelle C Ferron
- Geisel School of Medicine at Dartmouth, and Department of Psychiatry, Dartmouth-Hitchcock, Lebanon, NH
| | | | - Daniel Coletti
- Department of Psychiatry, Hillside Hospital, New York, NY
| | - Pamela Geiger
- Geisel School of Medicine at Dartmouth, and Department of Psychiatry, Dartmouth-Hitchcock, Lebanon, NH
| | - Timothy Devitt
- Departments of Clinical Operations and Research, Thresholds, Inc, Chicago, IL
| | - Vanessa Klodnick
- Departments of Clinical Operations and Research, Thresholds, Inc, Chicago, IL
| | | | - Haiyi Xie
- Geisel School of Medicine at Dartmouth, and Department of Psychiatry, Dartmouth-Hitchcock, Lebanon, NH
| | - Mary Ann Greene
- Geisel School of Medicine at Dartmouth, and Department of Psychiatry, Dartmouth-Hitchcock, Lebanon, NH
| | - Douglas Ziedonis
- Department of Psychiatry, University of Massachusetts, Worchester, MA
| | - Robert E Drake
- Geisel School of Medicine at Dartmouth, and Department of Psychiatry, Dartmouth-Hitchcock, Lebanon, NH
| | - Gregory J McHugo
- Geisel School of Medicine at Dartmouth, and Department of Psychiatry, Dartmouth-Hitchcock, Lebanon, NH
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Kuo SC, Yeh YW, Chen CY, Huang CC, Chen TY, Yen CH, Liang CS, Ho PS, Lu RB, Huang SY. Novelty seeking mediates the effect of DRD3 variation on onset age of amphetamine dependence in Han Chinese population. Eur Arch Psychiatry Clin Neurosci 2018; 268:249-260. [PMID: 28028606 DOI: 10.1007/s00406-016-0754-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 12/13/2016] [Indexed: 01/13/2023]
Abstract
The dopamine receptor D3 (DRD3) gene, one of the candidate genes for amphetamine dependence (AD), is involved in the mesolimbic dopaminergic system, implicated as the underlying mechanism of addiction. Our case-control study aimed to investigate whether the DRD3 gene is associated with the susceptibility to AD and specific personality traits in AD patients. A total of 1060 unrelated Han Chinese subjects (559 AD patients and 501 controls) were screened using the same assessment tool and genotyped for eight DRD3 polymorphisms. All patients met the DSM-IV-TR criteria for AD, and personality traits of 539 were assessed using a Tridimensional Personality Questionnaire. Furthermore, AD individuals were divided into four clinical subgroups based on gender and psychosis status, to reduce the clinical heterogeneity. We found that the ATA haplotype combination for SNPs rs324029, rs6280, and rs9825563, respectively, was significantly associated with total AD patients (p = 0.0003 after 10,000 permutations). Similar results were observed in the both male and non-psychosis subgroup but not in other subgroups. In addition, DRD3 rs9825563 may influence onset age of drug use, partially mediated by novelty seeking in the non-psychosis AD group. In conclusion, DRD3 is a potential genetic factor in the susceptibility to AD and is associated with onset age of drug use through interaction with novelty seeking in a specific patient group in the Han Chinese population.
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Affiliation(s)
- Shin-Chang Kuo
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, No. 325, Cheng-Kung Road, Sec. 2, Nei-Hu District, Taipei, 144, Taiwan, ROC
| | - Yi-Wei Yeh
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, No. 325, Cheng-Kung Road, Sec. 2, Nei-Hu District, Taipei, 144, Taiwan, ROC
| | - Chun-Yen Chen
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, No. 325, Cheng-Kung Road, Sec. 2, Nei-Hu District, Taipei, 144, Taiwan, ROC
| | - Chang-Chih Huang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Psychiatry, Taipei Branch, Buddhist Tzu Chi General Hospital, Taipei, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, No. 325, Cheng-Kung Road, Sec. 2, Nei-Hu District, Taipei, 144, Taiwan, ROC
| | - Che-Hung Yen
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.,Division of Neurology, Department of Internal Medicine, Chiayi Yang-Ming Hospital, Chiayi, Taiwan, ROC
| | - Chih-Sung Liang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Pei-Shen Ho
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Ru-Band Lu
- Institute of Behavior Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
| | - San-Yuan Huang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC. .,Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, No. 325, Cheng-Kung Road, Sec. 2, Nei-Hu District, Taipei, 144, Taiwan, ROC.
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Kozlowski LT, Warner KE. Adolescents and e-cigarettes: Objects of concern may appear larger than they are. Drug Alcohol Depend 2017; 174:209-214. [PMID: 29350617 DOI: 10.1016/j.drugalcdep.2017.01.001] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Lynn T Kozlowski
- University at Buffalo, State University of New York, School of Public Health and Health Professions, Department of Community Health and Health Behavior, 323 Kimball Tower, 3435 Main St., Buffalo, NY 14214-028, United States.
| | - Kenneth E Warner
- University of Michigan, School of Public Health, Department of Health Management & Policy, Room M3517 SPH II, 1415 Washington Heights, Ann Arbor, MI 48109-2029, United States
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Hussong AM, Ennett ST, Cox MJ, Haroon M. A systematic review of the unique prospective association of negative affect symptoms and adolescent substance use controlling for externalizing symptoms. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017; 31:137-147. [PMID: 28134539 DOI: 10.1037/adb0000247] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This systematic review examines whether negative affect symptoms (i.e., anxiety, depression, and internalizing symptoms more broadly) predict subsequent adolescent substance use after controlling for co-occurring externalizing symptoms. Following PRISMA procedures, we identified 61 studies that tested the association of interest. Findings varied depending on the type of negative affect symptom and to some extent on the substance use outcome. The most consistent associations were evident for depressive symptoms, particularly as predictors of substance use composite scores. No clear association between anxiety and substance use or between internalizing symptoms and substance use was evident, and indeed these associations were as often negative as positive. Mixed findings regarding the depression-substance use association, however, also call for greater attention to potential moderating factors that may help define who, when, and in what context depression serves as an important risk factor for later substance use above and beyond risk associated with externalizing symptoms. (PsycINFO Database Record
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Affiliation(s)
- Andrea M Hussong
- Center for Developmental Science, The University of North Carolina at Chapel Hill
| | - Susan T Ennett
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill
| | - Melissa J Cox
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill
| | - Maleeha Haroon
- Center for Developmental Science and Department of Psychology & Neuroscience, The University of North Carolina at Chapel Hill
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8
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Fluharty M, Taylor AE, Grabski M, Munafò MR. The Association of Cigarette Smoking With Depression and Anxiety: A Systematic Review. Nicotine Tob Res 2017; 19:3-13. [PMID: 27199385 PMCID: PMC5157710 DOI: 10.1093/ntr/ntw140] [Citation(s) in RCA: 616] [Impact Index Per Article: 88.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 05/13/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Many studies report a positive association between smoking and mental illness. However, the literature remains mixed regarding the direction of this association. We therefore conducted a systematic review evaluating the association of smoking and depression and/or anxiety in longitudinal studies. METHODS Studies were identified by searching PubMed, Scopus, and Web of Science and were included if they: (1) used human participants, (2) were longitudinal, (3) reported primary data, (4) had smoking as an exposure and depression and/or anxiety as an outcome, or (5) had depression and/or anxiety as the exposure and smoking as an outcome. RESULTS Outcomes from 148 studies were categorized into: smoking onset, smoking status, smoking heaviness, tobacco dependence, and smoking trajectory. The results for each category varied substantially, with evidence for positive associations in both directions (smoking to later mental health and mental health to later smoking) as well as null findings. Overall, nearly half the studies reported that baseline depression/anxiety was associated with some type of later smoking behavior, while over a third found evidence that a smoking exposure was associated with later depression/anxiety. However, there were few studies directly supporting a bidirectional model of smoking and anxiety, and very few studies reporting null results. CONCLUSIONS The literature on the prospective association between smoking and depression and anxiety is inconsistent in terms of the direction of association most strongly supported. This suggests the need for future studies that employ different methodologies, such as Mendelian randomization (MR), which will allow us to draw stronger causal inferences. IMPLICATIONS We systematically reviewed longitudinal studies on the association of different aspects of smoking behavior with depression and anxiety. The results varied considerably, with evidence for smoking both associated with subsequent depression and anxiety, and vice versa. Few studies supported a bidirectional relationship, or reported null results, and no clear patterns by gender, ethnicity, clinical status, length to follow-up, or diagnostic test. Suggesting that despite advantages of longitudinal studies, they cannot alone provide strong evidence of causality. Therefore, future studies investigating this association should employ different methods allowing for stronger causal inferences to be made, such as MR.
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Affiliation(s)
- Meg Fluharty
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom;
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
| | - Amy E Taylor
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
| | - Meryem Grabski
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
| | - Marcus R Munafò
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
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DRD3 variation associates with early-onset heroin dependence, but not specific personality traits. Prog Neuropsychopharmacol Biol Psychiatry 2014; 51:1-8. [PMID: 24398431 DOI: 10.1016/j.pnpbp.2013.12.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 12/19/2013] [Accepted: 12/26/2013] [Indexed: 02/02/2023]
Abstract
Dopamine D3 receptor-mediated pathways are involved in the mechanism of addiction, and genetic factors play a role in the vulnerability to heroin dependence. The aim of this study was to examine whether the corresponding gene, DRD3, is associated with the development of heroin dependence and specific personality traits in HD patients. Eight polymorphisms in DRD3 were analyzed in 1067 unrelated Han Chinese subjects (566 heroin dependence patients and 501 controls). All participants were screened using the same assessment tool and all patients met the criteria for heroin dependence. A Tridimensional Personality Questionnaire was used to assess personality traits in 276 heroin dependence patients. In addition, heroin dependence patients were divided into 4 clinical subgroups based on age-of-onset and family history of substance abuse, to reduce the clinical heterogeneity. The rs6280 and rs9825563 variants showed association with the development of early-onset heroin dependence. The GTA haplotype frequency in the block (rs324029, rs6280, rs9825563) was significantly associated with early-onset heroin dependence (p=0.003). However, these significant associations were weaker after Bonferroni's correction. In addition, these DRD3 polymorphisms did not influence novelty seeking and harm avoidance scores in HD patients. DRD3 is possibly a genetic factor in the development of early-onset heroin dependence, but is not associated with specific personality traits in these patients among the Han Chinese population.
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Miettunen J, Murray GK, Jones PB, Mäki P, Ebeling H, Taanila A, Joukamaa M, Savolainen J, Törmänen S, Järvelin MR, Veijola J, Moilanen I. Longitudinal associations between childhood and adulthood externalizing and internalizing psychopathology and adolescent substance use. Psychol Med 2014; 44:1727-1738. [PMID: 24028974 DOI: 10.1017/s0033291713002328] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Emotional and behavioral problems are commonly associated with substance use in adolescence but it is unclear whether substance use precedes or follows mental health problems. The aim was to investigate longitudinal associations between externalizing and internalizing psychopathology and substance use in a prospective population study design. METHOD The sample was the Northern Finland Birth Cohort 1986 Study (NFBC 1986; n = 6349; 3103 males). Externalizing and internalizing mental health problems were assessed at age 8 years (Rutter scales), substance use and externalizing and internalizing problems [Youth Self-Report (YSR)] at age 15-16 years, and hospital diagnoses for internalizing disorders (age 25) and criminal offences (age 20) from nationwide registers in adulthood. RESULTS Externalizing problems at age 8 were associated with later substance use. After adjustment for sociodemographic factors, parental alcohol use and psychiatric disorders, and earlier externalizing and internalizing problems, substance use predicted criminality, especially among males, with the highest odds ratio (OR) for cannabis use [adjusted OR 6.2, 95% confidence interval (CI) 3.1-12.7]. Early internalizing problems were not a risk for later substance use. Female adolescent cannabis (OR 3.2, 95% CI 1.4-7.3) and alcohol (OR 2.1, 95% CI 1.1-4.2) use predicted internalizing disorders in adulthood. CONCLUSIONS Externalizing problems precede adolescent substance use in both genders, whereas, among boys, substance use also precedes criminal offences. Internalizing problems may follow substance use in females. These associations were robust even when taking into account previous mental health problems.
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Affiliation(s)
- J Miettunen
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Finland
| | - G K Murray
- Department of Psychiatry, University of Cambridge and CPFT, UK
| | - P B Jones
- Department of Psychiatry, University of Cambridge and CPFT, UK
| | - P Mäki
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Finland
| | - H Ebeling
- Clinic of Child Psychiatry, University of Oulu and Oulu University Hospital, Finland
| | - A Taanila
- Institute of Health Sciences, University of Oulu, Finland
| | - M Joukamaa
- Social Psychiatry Unit, School of Health Sciences, University of Tampere, Finland
| | - J Savolainen
- School of Criminology and Criminal Justice, University of Nebraska at Omaha, NE, USA
| | - S Törmänen
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Finland
| | - M-R Järvelin
- Institute of Health Sciences, University of Oulu, Finland
| | - J Veijola
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Finland
| | - I Moilanen
- Clinic of Child Psychiatry, University of Oulu and Oulu University Hospital, Finland
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Abstract
BACKGROUND The relationship between prenatal tobacco exposure and hyperactivity remains controversial. To mitigate limitations of prior studies, we used a strategy involving comparison of maternal and paternal smoking reports in a historical sample where smoking during pregnancy was common. METHOD Data were drawn from a longitudinally followed subsample of the Child Health and Development Study (n = 1752), a population-based pregnancy cohort ascertained in 1961-1963 in California. Maternal prenatal smoking was common (33.4%). Maternal and paternal smoking patterns were assessed at three time points by mother report. Hyperactivity was assessed at the mean of age of 10 years based on mother report to a personality inventory. RESULTS Unadjusted, maternal smoking during pregnancy was associated with offspring hyperactivity [β = 0.22, 95% confidence interval (CI) 0.11-0.33] and, to a similar degree, when the father smoked (β = 0.18, 95% CI 0.07-0.30). After adjustment, maternal smoking remained robustly predictive of offspring hyperactivity (β = 0.25, 95% CI 0.09-0.40) but father smoking was not (β = 0.02, 95% CI -0.20 to 0.24). When examined among the pairs matched on propensity score, mother smoking was robustly related to offspring hyperactivity whether the father smoked (β = 0.26, 95% CI 0.03-0.49) or did not smoke (β = 0.30, 95% CI 0.04-0.57). By number of cigarettes, associations with hyperactivity were present for 10-19 and 20+ cigarettes per day among mothers. CONCLUSIONS In a pregnancy cohort recruited in a time period in which smoking during pregnancy was common, we document associations between prenatal smoking exposure and offspring hyperactivity. Novel approaches to inferring causality continue to be necessary in describing the potential adverse consequences of prenatal smoking exposure later in life.
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Affiliation(s)
- K. M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - G. Davey Smith
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
| | - E. Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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Hu MC, Griesler PC, Schaffran C, Wall MM, Kandel DB. Trajectories of criteria of nicotine dependence from adolescence to early adulthood. Drug Alcohol Depend 2012; 125:283-9. [PMID: 22513378 PMCID: PMC3592202 DOI: 10.1016/j.drugalcdep.2012.03.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Revised: 02/09/2012] [Accepted: 03/01/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND To identify patterns and correlates of developmental trajectories of DSM-IV nicotine dependence criteria from adolescence to early adulthood. METHODS The analytical sample of lifetime smokers (N=877) is from a longitudinal cohort of 6th-10th graders drawn from an urban school system. Subjects were interviewed 5 times at 6-month intervals and once 4.5 years later. Growth mixture models were estimated to identify trajectories of DSM-IV nicotine dependence criteria over ages 12-23. RESULTS A four-class solution fitted the data best: No dependence criteria (class 1, 32.0%); early onset/chronic course (class 2, 26.1%); early onset/remission (class 3, 15.4%); late onset (class 4, 26.5%). There appeared to be three critical periods. At ages 12-15, symptoms increased rapidly. As of age 16, the early onset/chronic class stabilized at high levels of symptoms, the early onset/remission class started its symptomatic decline, and the late onset class experienced a sharp increase in symptoms. At age 20, there was a convergence in the prevalence of symptoms experienced at high (classes 2 and 4) and low levels (classes 1 and 3). Extensiveness of smoking and marijuana use were associated with higher baseline levels of nicotine dependence criteria. Anxiety disorders were associated with all three symptomatic trajectories. Parental smoking and nicotine dependence were associated specifically with the early/chronic class, while pleasant initial sensitivity and earlier onset ages of cigarette and marijuana use characterized the two early onset classes (2 and 3). CONCLUSIONS Trajectories of dependence criteria constitute an advantageous phenotype for research and intervention over static summaries of smoking behaviors.
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Affiliation(s)
- Mei-Chen Hu
- Department of Psychiatry, Columbia University, New York, NY 10032, USA
| | | | | | - Melanie M. Wall
- Department of Psychiatry, Columbia University, New York, NY 10032, USA,Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Denise B. Kandel
- Department of Psychiatry, Columbia University, New York, NY 10032, USA,New York State Psychiatric Institute, New York, NY 10032, USA,Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA,Corresponding author at: Columbia University, 1051 Riverside Drive, Unit 20, New York, NY 10032, USA. Tel.: +1 212 304 7080; fax: +1 212 305 1933., (D.B. Kandel)
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13
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Chen LS, Xian H, Grucza RA, Saccone NL, Wang JC, Johnson EO, Breslau N, Hatsukami D, Bierut LJ. Nicotine dependence and comorbid psychiatric disorders: examination of specific genetic variants in the CHRNA5-A3-B4 nicotinic receptor genes. Drug Alcohol Depend 2012; 123 Suppl 1:S42-51. [PMID: 22336398 PMCID: PMC3376673 DOI: 10.1016/j.drugalcdep.2012.01.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 01/13/2012] [Accepted: 01/17/2012] [Indexed: 01/28/2023]
Abstract
BACKGROUND The associations between nicotine dependence and specific variants in the nicotinic receptor CHRNA5-A3-B4 subunit genes are irrefutable with replications in many studies. The relationship between the newly identified genetic risk variants for nicotine dependence and comorbid psychiatric disorders is unclear. We examined whether these genetic variants were associated with comorbid disorders and whether comorbid psychiatric disorders modified the genetic risk of nicotine dependence. METHODS In a case control study of nicotine dependence with 2032 subjects of European descent, we used logistic regression models to examine the pleiotropy and risk moderation. Comorbid disorders examined were alcohol dependence, cannabis dependence, major depressive disorder, panic attack, social phobia, posttraumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD), conduct disorder, and antisocial personality disorder (ASPD). RESULTS Nicotine dependence was associated with every examined comorbid psychiatric disorders, with odds ratio varying from 1.75 to 3.33. No evidence supported the associations between the genetic variants and the comorbid disorders (pleiotropy). No evidence suggested that the risks for nicotine dependence associated with the genetic variants vary with comorbid psychiatric disorders in general, but the power was limited in detecting interactions. CONCLUSIONS The genetic risks of nicotine dependence associated with the CHRNA5-A3-B4 subunit genes are specific, and not shared among commonly comorbid psychiatric disorders. The risks for nicotine dependence associated with these genetic variants are not modified by comorbid psychiatric disorders such as major depressive disorder or alcohol dependence. However, the power is an important limitation in studying the interplay of comorbidity and genetic variants.
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Affiliation(s)
- Li-Shiun Chen
- Department of Psychiatry, Washington University, St Louis, MO 63110, USA.
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14
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Humphreys KL, Mehta N, Lee SS. Association of parental ADHD and depression with externalizing and internalizing dimensions of child psychopathology. J Atten Disord 2012; 16:267-75. [PMID: 21173429 PMCID: PMC6613577 DOI: 10.1177/1087054710387264] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To study the independent association of parental depression and ADHD on three dimensions of child psychopathology among 178 children aged 5 to 10 years. METHOD Self-reported measures of parental depression and ADHD as well as rating scales and structure diagnostic interviews of child internalizing, ADHD, and externalizing problems were obtained. RESULTS Structural equation modeling indicated that parental ADHD was positively associated with a broad child problems factor after a second-order factor of child problems best accounted for the high intercorrelations among the internalizing, ADHD, and externalizing child psychopathology factors. Parental depression did not significantly predict the second-order child problems factor, but it specifically predicted the child internalizing factor. CONCLUSION These results suggest that parental ADHD may be a nonspecific risk factor for child psychopathology broadly, whereas parental depression may function as a specific risk factor for child internalizing problems.
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15
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Bahramnejad A, Rabani-Bavojdan M, Rabani-Bavojdan M. The relationship of metacognitive beliefs and tendency to addiction in sistan and baluchistan university, zahedan, iran. ADDICTION & HEALTH 2012; 4:65-72. [PMID: 24494138 PMCID: PMC3905549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 11/16/2011] [Indexed: 10/31/2022]
Abstract
BACKGROUND The aim of this study was to examine the relationship between metacognitive beliefs and the tendency to addiction in the students of the University of Sistan and Baluchistan, located in the South-East of Iran, during the academic year of 2009-2010. METHODS This was a descriptive, correlational study, and the statistical samples were 200 male BSc students selected with cluster random sampling procedures from the three schools of Literature, Science, and Engineering. The measuring tools were the metacognition Questionnaire-30 (MCQ-30), and Addiction Potential Scale. Data analysis was done by the SPSS software using the Pearson correlation coefficient, and multiple regressions. FINDINGS The result of data analysis showed that metacognitive beliefs and their subscales had a significant negative relationship with the tendency toward addiction (P < 0.01). The results show that fewer metacognitive characteristics are associated with a high tendency to addiction. CONCLUSION The findings of this study indicate that disturbed metacognitive beliefs is a good predictor of students tendency to addiction, therefore, teaching strategies metacognition is important in the prevention of young people's Tendency toward- addiction.
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Affiliation(s)
- Ali Bahramnejad
- Student of MPH, Department of Psycho Social Health, School of Health, Kerman University of Medical Sciences, Kerman, Iran.,Correspondence to: Ali Bahramnejad,
| | - Marjan Rabani-Bavojdan
- Department of Psychology, School of Educational Sciences and Psychology, Sistan and Balochestan University, Zahedan, Iran
| | - Mozhgan Rabani-Bavojdan
- Department of Psychology, School of Literature and Humanities, Shahid Bahonar University of Kerman, Kerman, Iran
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16
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Goodwin RD, Pagura J, Spiwak R, Lemeshow A, Sareen J. Predictors of persistent nicotine dependence among adults in the United States. Drug Alcohol Depend 2011; 118:127-33. [PMID: 21514748 PMCID: PMC3337717 DOI: 10.1016/j.drugalcdep.2011.03.010] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Revised: 03/08/2011] [Accepted: 03/11/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Evidence suggests that nicotine dependence is the key barrier to successful smoking cessation. No previous study has documented predictors of persistent nicotine dependence among adults in the community. The goal of this study is to prospectively identify predictors of continued nicotine dependence over a 3-year period among adults. METHODS Data were drawn from Waves I and II of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a nationally representative sample of 34,653 adults in the United States. Logistic regression analyses were used to estimate the odds of persistent nicotine dependence at Wave 2 given the presence of various sociodemographic and psychiatric predictors at Wave 1. RESULTS Mood, anxiety, personality and illicit substance use disorders were associated with significantly increased risk of persistent nicotine dependence. The strength of these relationships was attenuated slightly after adjusting for demographic differences, but remained statistically significant. Persistent nicotine dependence was more common among unmarried, younger females with lower income levels and lower educational attainment. CONCLUSIONS To our knowledge, this study is the first to prospectively identify predictors of persistent nicotine dependence among adults. Our results suggest that the incorporation of mental health treatment into alternative smoking cessation approaches may help to increase the effectiveness of these programs and that a greater focus of these services on vulnerable segments of the population is needed in order to reduce continued disparities in smoking in the general population.
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, Rm 1505, New York, NY 10032, USA.
| | - Jina Pagura
- Department of Psychiatry, University of Manitoba, PZ-430 PsycHealth Centre, 771 Bannatyne Avenue, Winnipeg, Manitoba, R3E 3N4
| | - Rae Spiwak
- Department of Psychiatry, University of Manitoba, PZ-430 PsycHealth Centre, 771 Bannatyne Avenue, Winnipeg, Manitoba, R3E 3N4
| | - Adina Lemeshow
- Department of Epidemiology, Mailman School of Public Health Columbia University, 722 West 168th St, Rm 1505, New York, New York 10032, Ph 212-342-0422, Fax 212-342-5168
| | - Jitender Sareen
- Department of Psychiatry, University of Manitoba, PZ-430 PsycHealth Centre, 771 Bannatyne Avenue, Winnipeg, Manitoba, R3E 3N4
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Hu MC, Griesler P, Schaffran C, Kandel D. Risk and protective factors for nicotine dependence in adolescence. J Child Psychol Psychiatry 2011; 52:1063-72. [PMID: 21250992 PMCID: PMC3133794 DOI: 10.1111/j.1469-7610.2010.02362.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND We investigated the role of psychosocial and proximal contextual factors on nicotine dependence in adolescence. METHODS Data on a multiethnic cohort of 6th to 10th graders from the Chicago public schools were obtained from four household interviews conducted with adolescents over two years and one interview with mothers. Structural equation models were estimated on 660 youths who had smoked cigarettes by the first interview. RESULTS Pleasant initial sensitivity to tobacco use, parental nicotine dependence (ND), adolescent ND and extensiveness of smoking at the initial interview had the strongest total effects on adolescent ND two years later. Perceived peer smoking and adolescent conduct problems were of lesser importance. Parental ND directly impacted adolescent ND two years later and had indirect effects through pleasant initial sensitivity and initial extensiveness of smoking. Parental depression affected initial adolescent dependence and depression but adolescent depression had no effect on ND. The model had greater explanatory power for males than females due partly to the stronger effect of conduct problems on dependence for males than females. CONCLUSIONS The findings underscore the importance of the initial drug experience and familial factors on adolescent nicotine dependence and highlight the factors to be the focus of efforts targeted toward preventing ND among adolescents.
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Affiliation(s)
| | | | | | - Denise Kandel
- Columbia University,New York State Psychiatric Institute
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18
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Maremmani I, Perugi G, Rovai L, Maremmani AGI, Pacini M, Canonico PL, Carbonato P, Mencacci C, Muscettola G, Pani L, Torta R, Vampini C, Akiskal HS. Are "social drugs" (tobacco, coffee and chocolate) related to the bipolar spectrum? J Affect Disord 2011; 133:227-33. [PMID: 21605911 DOI: 10.1016/j.jad.2011.04.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Accepted: 04/21/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND Across all ages and cultures, mankind has always used substances in order to induce pleasurable sensations or desirable psychophysical states. These substances, notably caffeine, tobacco, alcohol and chocolate, can be labeled 'social drugs'. METHODS We analyzed the social drug habits of 562 patients suffering from mood disorders, according to DSM-IV-R criteria (major depressive episode, recurrent depression, bipolar type I and II disorders and depression not otherwise specified). The sample was also divided into bipolar and non-bipolar according to Hypomania Check-list 32 (HCL-32), which proposes a broader concept of hypomania and soft bipolarity, comprising the spectrum of bipolar disorders proper, along with other, "softer" expressions of bipolarity intermediate between bipolar disorder and normality. RESULTS Using HCL-32 criteria, but DSM-IV-R criteria, a link was confirmed between bipolar spectrum and substance use including social drugs such as tobacco and coffee. LIMITATION Observational correlational study. CONCLUSION This study is in support of earlier theoretical formulations within the framework of the Pisa-San Diego collaboration.
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Affiliation(s)
- Icro Maremmani
- Department of Psychiatry, University of Pisa and G. De Lisio Institute of Behavioural Sciences, Pisa, Italy.
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19
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Li T, Yu S, Du J, Chen H, Jiang H, Xu K, Fu Y, Wang D, Zhao M. Role of novelty seeking personality traits as mediator of the association between COMT and onset age of drug use in Chinese heroin dependent patients. PLoS One 2011; 6:e22923. [PMID: 21857968 PMCID: PMC3157337 DOI: 10.1371/journal.pone.0022923] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 07/04/2011] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Personality traits such as novelty seeking (NS) are associated with substance dependence but the mechanism underlying this association remains uncertain. Previous studies have focused on the role of the dopamine pathway. OBJECTIVE Examine the relationships between allelic variants of the catechol-O-methyltransferase (COMT) gene, NS personality traits, and age of onset of drug use in heroin-dependent subjects in China. METHODS The 478 heroin dependent subjects from four drug rehabilitation centers in Shanghai who were genotyped for eight tagging single nucleotide polymorphisms (SNP) on the COMT gene completed the NS subscale from the Temperament and Character Inventory. Multivariate analyses were used to assess the potential mediating role of NS personality traits in the association between COMT gene variants and the age of onset of heroin use. PRINCIPAL FINDINGS AND CONCLUSIONS In the univariate analysis the COMT rs737866 gene variants were independently associated with both NS and age of onset of drug use: those with the TT genotype had higher NS subscale scores and an earlier onset age of heroin use than individuals with CT or CC genotypes. In the multivariate analysis the inclusion of the NS subscore variable weakened the relationship between the COMT rs737866 TT genotype and an earlier age of onset of drug use. Our findings that COMT is associated with both NS personality traits and with the age of onset of heroin use helps to clarify the complex relationship between genetic and psychological factors in the development of substance abuse.
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Affiliation(s)
- Ting Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shunying Yu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiang Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hanhui Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haifeng Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ke Xu
- Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Yingmei Fu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongxiang Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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20
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Counotte DS, Smit AB, Pattij T, Spijker S. Development of the motivational system during adolescence, and its sensitivity to disruption by nicotine. Dev Cogn Neurosci 2011; 1:430-43. [PMID: 22436565 DOI: 10.1016/j.dcn.2011.05.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 05/18/2011] [Accepted: 05/29/2011] [Indexed: 12/18/2022] Open
Abstract
The brain continues to develop during adolescence, and exposure to exogenous substances such as nicotine can exert long-lasting adaptations during this vulnerable period. In order to fully understand how nicotine affects the adolescent brain it is important to understand normal adolescent brain development. This review summarizes human and animal data on brain development, with emphasis on the prefrontal cortex, for its important function in executive control over behavior. Moreover, we discuss how nicotine exposure during adolescence can disrupt brain development bearing long-term consequences on executive cognitive function in adulthood.
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Affiliation(s)
- Danielle S Counotte
- Molecular and Cellular Neurobiology, Center for Neurogenomics & Cognitive Research (CNCR), VU University, The Netherlands.
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21
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Sousa NO, Grevet EH, Salgado CAI, Silva KL, Victor MM, Karam RG, Vitola ES, Picon FA, Zeni GD, Rohde LA, Belmonte-de-Abreu P, Bau CHD. Smoking and ADHD: an evaluation of self medication and behavioral disinhibition models based on comorbidity and personality patterns. J Psychiatr Res 2011; 45:829-34. [PMID: 21092985 DOI: 10.1016/j.jpsychires.2010.10.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2010] [Revised: 10/16/2010] [Accepted: 10/19/2010] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The prevalence of smoking is significantly increased among adults with Attention-Deficit/Hyperactivity Disorder (ADHD), and this association has a significant impact in both disorders, ascribed to either self-medication or behavioral disinhibition hypotheses. However, little is known about clinical variables associated with cigarette smoking among patients with ADHD. The present study evaluates comorbidity, demographic and personality profiles of patients with ADHD in relation to smoking status. METHODS Patients (n422) were evaluated in the adult ADHD outpatient clinic of Hospital de Clínicas de Porto Alegre. Diagnoses were based on DSM-IV criteria and interviews were performed with Portuguese version of K-SADS-E for ADHD and Oppositional-Defiant Disorder. Axis I psychiatric comorbidities were evaluated with the SCID-I and smoking behavior with Fagerström Test for Nicotine Dependence (FTND). Personality was evaluated with Cloninger's Temperament and Character Inventory (TCI). RESULTS The presence of smoking was strongly associated with externalizing characteristics as antisocial personality disorder (OR4.2) and substance dependence (OR6.5), but not with internalizing disorders. Moreover, smoking was associated with higher novelty seeking and lower harm avoidance scores. CONCLUSIONS Smoking initiation among patients with ADHD is consistent with a behavioral disinhibition profile beyond the possible role of self-medication in smoking persistence. Smoking in these patients is strongly associated with externalizing comorbid disorders.
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Affiliation(s)
- Nyvia O Sousa
- ADHD Outpatient Program - Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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Abstract
AIMS To examine bidirectional influences of onset of psychiatric disorders and nicotine dependence among adolescent smokers. DESIGN A prospective longitudinal cohort of adolescents and mothers drawn from a large city school system. Adolescents were interviewed five times and mothers three times over 2 years. SETTING Chicago, Illinois. PARTICIPANTS Subsample of adolescent smokers (n = 814). MEASUREMENTS Selected DSM-IV psychiatric disorders, nicotine dependence and selected risk factors were ascertained. FINDINGS Among lifetime smokers, 53.7% experienced at least one nicotine dependence criterion; 26.1% full dependence; 14.1% experienced an anxiety disorder, 18.8% a mood disorder and 29.5% a disruptive disorder. Nicotine dependence and psychiatric disorders were comorbid: nicotine-dependent youths had higher rates of individual and multiple disorders than those not dependent. Controlling for other covariates, mood disorder and nicotine dependence did not predict each other; anxiety disorder predicted nicotine dependence. Bidirectional influences were observed for disruptive disorder and nicotine dependence. Predictors of onset of full nicotine dependence included earlier onset age of tobacco use, high initial pleasant sensitivity to tobacco, alcohol and illicit drug use, abuse and dependence and parental nicotine dependence. Predictors of psychiatric disorder onset included gender, race/ethnicity, other psychiatric disorders, illicit drug abuse or dependence and parental depression and delinquency. CONCLUSIONS Initial pleasant experiences of smoking are predictive of later development of nicotine dependence. There may be reciprocal influences between disruptive disorder and development of nicotine dependence in adolescence, and intergenerational transmission of parental nicotine dependence and psychopathology.
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Affiliation(s)
- Pamela C. Griesler
- New York State Psychiatric Institute, New York, NY, USA,Department of Psychiatry, Columbia University, New York, NY, USA
| | - Mei-Chen Hu
- Department of Psychiatry, Columbia University, New York, NY, USA
| | | | - Denise B. Kandel
- New York State Psychiatric Institute, New York, NY, USA,Department of Psychiatry, Columbia University, New York, NY, USA,Mailman School of Public Health, Columbia University, New York, NY, USA
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DeHay T, Morris C, May MG, Devine K, Waxmonsky J. Tobacco use in youth with mental illnesses. J Behav Med 2011; 35:139-48. [PMID: 21479646 DOI: 10.1007/s10865-011-9336-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 03/07/2011] [Indexed: 01/16/2023]
Abstract
Despite an abundance of literature documenting the prevalence and dangers of youth tobacco use, there is a relative dearth of literature in the area of effective cessation treatments for youth (Fiore et al. in Clinical tobacco guideline: treating tobacco use and dependence, 2008). Additionally, although it has been widely accepted that mental illness is highly correlated with tobacco use and dependence, little research has been done to support prevention and cessation efforts for youth with mental illnesses. This paper summarizes the literature on tobacco use and cessation in youth, with a focus on describing the existing knowledge base for youth with mental illnesses.
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Affiliation(s)
- Tamara DeHay
- Western Interstate Commission for Higher Education, Mental Health Program, Boulder, CO, USA.
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24
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Amin TT, Amr MAM, Zaza BO. Psychosocial predictors of smoking among secondary school students in Al-Hassa, Saudi Arabia. J Behav Med 2011; 34:339-50. [PMID: 21286799 DOI: 10.1007/s10865-011-9319-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2010] [Accepted: 01/19/2011] [Indexed: 10/18/2022]
Abstract
The objective of this study was to determine the prevalence and determinants of the current smoking status among secondary school students in Al-Hassa, Saudi Arabia. A total of 1,652 secondary school adolescents were selected by multistage proportionate sampling method. Data collection was carried out through self-administered anonymous questionnaire including: Arabic version of the Global Youth Tobacco Survey, modified Fagerstrom Test for Nicotine Dependence and Patient Health Questionnaire to asses for anxiety and depressive disorders. This study revealed that the prevalence of current smokers was 21.7. Seventy-one percent of current cigarette smokers were minimally nicotine dependent. Major depressive and anxiety disorders were significantly higher among current smokers. Hierarchical regression analysis shows that, male, older age, smoking of close relatives and friends, anxiety disorders and socializing motives were statistically significant determinants of current smoking status among the included adolescents. Family members should be made aware of the detrimental influence their smoking behavior has on their youth. Counseling and preventive psychiatric services should be an integral part of the clinical facilities caring for secondary school students.
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Affiliation(s)
- Tarek Tawfik Amin
- Family and Community Medicine Department, College of Medicine-Al Hassa, King Faisal University, Al-Hassa 31982, Saudi Arabia.
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25
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Changes in genetic and environmental influences on the development of nicotine dependence and major depressive disorder from middle adolescence to early adulthood. Dev Psychopathol 2011; 22:831-48. [PMID: 20883585 DOI: 10.1017/s0954579410000490] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This longitudinal study used a representative community sample of same-sex twins (485 monozygotic pairs, 271 dizygotic pairs) to study longitudinal changes in genetic and environmental influences on nicotine dependence (NicD) symptoms and major depressive disorder (MDD) symptoms and the longitudinal relationships between NicD and MDD symptoms at three relatively discrete ages spanning middle adolescence to early adulthood (ages 15, 18, and 21). Clinical interviews were used to assess NicD and MDD symptoms lifetime at age 15 and during the previous 3 years at the two subsequent assessments. Biometric models revealed similar patterns of findings for NicD and MDD. Heritability increased with age, particularly between ages 15 and 18. Shared environmental influences were small, and the proportion of variance attributed to shared environmental influences decreased with age. Nonshared environmental influences were moderate to large in magnitude and were entirely age specific. Both NicD and MDD symptoms showed considerable stability from age 15 to 21, and at each age those with one disorder showed elevated rates of the other. However, a cross-lagged model revealed no longitudinal predictive relationships between MDD symptoms and NicD symptoms after accounting for stability of symptoms within disorders. In summary, the transition between middle and late adolescence is a critical period for developmental shifts in the magnitudes of genetic and environmental influences on both MDD and NicD symptoms. Despite similarities in the development of genetic and environmental influences for the two phenotypes, the association between NicD and MDD reflects concurrent covariation rather than one phenotype being an antecedent influence on the subsequent development of the other.
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26
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Goodman A. Substance use and common child mental health problems: examining longitudinal associations in a British sample. Addiction 2010; 105:1484-96. [PMID: 20528814 DOI: 10.1111/j.1360-0443.2010.02981.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To examine the longitudinal associations in both directions between mental health and substance use in adolescence. DESIGN Three-year longitudinal cohort. SETTING Britain (nationally representative sample). PARTICIPANTS 3607 youths aged 11-16 years at baseline. MEASUREMENTS Externalizing and internalizing mental health problems were measured using brief questionnaires (parent-reported Strengths and Difficulties Questionnaire) and diagnostic interviews, including clinician-rated diagnoses of mental disorder. Substance use was measured by youth self-report, and included regular smoking, frequent alcohol consumption, regular cannabis use and ever taking other illicit drugs. FINDINGS Externalizing (specifically behavioural) problems at baseline independently predicted all forms of substance use, with a particularly strong effect on smoking. In all cases this association showed a dose-response relationship. In contrast, although internalizing problems had a strong univariable association with smoking, this disappeared after adjusting for comorbid externalizing problems. There was little or no evidence that baseline substance use predicted mental health at follow-up. CONCLUSIONS Externalizing problems predict adolescent substance use, and adjusting for comorbid externalizing problems is vital when investigating the effects of internalizing problems. A dose-response effect of externalizing problems is seen across the full range. Programmes seeking to prevent adolescent substance use by reducing externalizing problems may therefore wish to consider population-wide interventions rather than targeting individuals only at the negative extreme.
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Affiliation(s)
- Anna Goodman
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.
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27
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An investigation of cigarette smoking behavior and nicotine dependence among Chinese opiate addicts. Addict Behav 2009; 34:955-8. [PMID: 19559539 DOI: 10.1016/j.addbeh.2009.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Revised: 05/22/2009] [Accepted: 06/01/2009] [Indexed: 11/23/2022]
Abstract
To explore the characteristics of nicotine dependence among Chinese opiate addicts, a survey was conducted among 357 opiate addicts in Drug Detoxification and Rehabilitation Center from 4 different provinces by using a self-designed questionnaire and Fagerström Test for Nicotine Dependence (FTND). Among the 357 opiate addicts, 355 (99.4%) had the history of cigarette smoking and the mean cigarette smoked per day were 19.1, 34.9, 21.5 and 21.5 sticks during the time of before drug taking, addiction phase, abstinence period and after abstinence respectively. Among 347 smokers with FTND score, 67.2% were severe nicotine dependence (FTND score > or =7.0). The lower education degree, injection, poly-drug use and 3 or more relapse were dependently associated with the severe nicotine dependence, and the adjusted odds ratio (OR) were 3.8 (1.5-10.0), 2.3 (1.3-4.0), 3.7 (2.1-6.5) and 1.9 (1.1-3.4) respectively. This study exhibited high rate of cigarette smoking in Chinese opiate addicts and the majority had severe nicotine dependence and suggested that a comprehensive intervention of cigarette smoking should be paid attention to during substance abuse treatment in China.
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Dome P, Lazary J, Kalapos MP, Rihmer Z. Smoking, nicotine and neuropsychiatric disorders. Neurosci Biobehav Rev 2009; 34:295-342. [PMID: 19665479 DOI: 10.1016/j.neubiorev.2009.07.013] [Citation(s) in RCA: 149] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Revised: 07/23/2009] [Accepted: 07/30/2009] [Indexed: 12/20/2022]
Abstract
Tobacco smoking is an extremely addictive and harmful form of nicotine (NIC) consumption, but unfortunately also the most prevalent. Although disproportionately high frequencies of smoking and its health consequences among psychiatric patients are widely known, the neurobiological background of this epidemiological association is still obscure. The diverse neuroactive effects of NIC and some other major tobacco smoke constituents in the central nervous system may underlie this association. This present paper summarizes the pharmacology of NIC and its receptors (nAChR) based on a systematic review of the literature. The role of the brain's reward system(s) in NIC addiction and the results of functional and structural neuroimaging studies on smoking-related states and behaviors (i.e. dependence, craving, withdrawal) are also discussed. In addition, the epidemiological, neurobiological, and genetic aspects of smoking in several specific neuropsychiatric disorders are reviewed and the clinical relevance of smoking in these disease states addressed.
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Affiliation(s)
- Peter Dome
- Department of Clinical and Theoretical Mental Health, Kutvolgyi Clinical Center, Semmelweis University, Faculty of Medicine, Kutvolgyi ut 4, 1125 Budapest, Hungary.
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Subramaniam M, Cheok C, Lee IM, Pek E, Verma S, Wong J, Chong SA. Nicotine dependence and psychiatric disorders among young males in Singapore. Nicotine Tob Res 2009; 11:1107-13. [PMID: 19633276 DOI: 10.1093/ntr/ntp108] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION While the risk for a number of medical illnesses is well established for those who smoke, the risk for psychiatric disorders is not so well studied in Singapore. OBJECTIVES This study sought to establish the lifetime prevalence of nicotine dependence in a population of young males in Singapore and to establish its relationship with other psychiatric disorders. METHODS The study was conducted among a cohort of males reporting for their mandatory physical examination prior to their enlistment for National Service in a 1-year period between August 2004 and August 2005. Definitive diagnoses in accordance with DSM-IV criteria were made with the Composite International Diagnostic Interview (CIDI). RESULTS In the population of 9,702 males assessed by CIDI, the prevalence of nicotine dependence was 12.3%. Academic attainments were significantly poorer in those with nicotine dependence than those without dependence. Nicotine dependence was most strongly associated with delusional disorder and major depressive disorder, which remained even after adjusting for ethnicity and educational attainments (odds ratio [OR] of 59.8 for delusional disorder and OR of 36.3 for major depressive disorder). DISCUSSION Our study highlights the pervasive extent of nicotine dependence among a population of young men. The pervasiveness of nicotine dependence across different psychiatric disorders suggests either a shared biological substrate or a common consequence of these disorders.
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Abstract
The core nature of nicotine dependence is evident in wide variations in how individuals become and remain smokers. Individuals with pre-existing behavioral traits are more likely to develop nicotine dependence and experience difficulty when attempting to quit. Many molecular factors likely contribute to individual variations in the development of nicotine dependence and behavioral traits in complex manners. However, the identification of such molecules has been hampered by the phenotypic complexity of nicotine dependence and the complex ways molecules affect elements of nicotine dependence. We hypothesize that nicotine dependence is, in part, a result of interactions between nicotine and pre-existing behavioral traits. This perspective suggests that the identification of the molecular bases of such pre-existing behavioral traits will contribute to the development of effective methods for reducing smoking dependence and for helping smokers to quit.
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Affiliation(s)
- N Hiroi
- Department of Psychiatry and Behavioral Sciences, Laboratory of Molecular Psychobiology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
| | - D Scott
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, NY, USA
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