Smoking and major depression. A causal analysis.
Smoking and major depression. A causal analysis.
复制标题
DOI：
10.1001/archpsyc.1993.01820130038007
复制
发表时间：
1993
影响因子：
--
通讯作者：
K. Kendler;M. Neale;C. Maclean;A. Heath;L. Eaves;R. Kessler
中科院分区：
文献类型：
--
作者：
K. Kendler;M. Neale;C. Maclean;A. Heath;L. Eaves;R. Kessler
在基于人口的登记中对 1566 名女性双胞胎进行个人评估后，平均终生每日吸烟量与终生患病率以及前瞻性评估的重度抑郁症 (MD) 1 年患病率密切相关。使用 cotwin 控制方法，我们评估了吸烟与终生 MD 之间的关联是因果关系还是非因果关系。虽然在整个样本中，考虑到终生MD病史，曾经吸烟的相对风险（95%置信区间）为1.48（1.30至1.65），但在MD病史不一致的双卵和同卵双胞胎中，该相对风险分别为1.18（0.88至1.47）和0.98（0.71至1.26）。在整个样本中，曾吸烟的MD病史的相对风险为1.60（1.39至1.83），而在吸烟不一致的异卵双胞胎和同卵双胞胎中，该风险分别为1.29（0.87至1.74）和0.96（0.59至1.42）。控制个人吸烟史，吸烟家族史预测MD风险；控制MD个人史后，MD家族史预测吸烟。最拟合的双变量双胞胎模型表明，终生吸烟与终生MD之间的关系仅由易患这两种疾病的基因决定。这些结果表明，女性吸烟与MD之间的关系并不是因果关系，而主要是由家族因素引起的，这些因素可能是遗传性的，这些因素容易导致吸烟和MD。
Among 1566 personally evaluated female twins from a population-based register, average lifetime daily cigarette consumption was strongly related to lifetime prevalence and to prospectively assessed 1-year prevalence of major depression (MD). Using the cotwin control method, we evaluated whether the association between smoking and lifetime MD was causal or noncausal. While the relative risk (95% confidence interval) for ever smoking given a lifetime history of MD was 1.48 (1.30 to 1.65) in the entire sample, it was 1.18 (0.88 to 1.47) and 0.98 (0.71 to 1.26), respectively, in dizygotic and monozygotic twin pairs discordant for a history of MD. The relative risk for a history of MD given ever smoking was 1.60 (1.39 to 1.83) in the entire sample, while in dizygotic and monozygotic twins discordant for smoking, it was 1.29 (0.87 to 1.74) and 0.96 (0.59 to 1.42), respectively. Controlling for personal smoking history, family history of smoking predicted risk for MD; controlling for the personal history of MD, family history of MD predicted smoking. The best-fitting bivariate twin model suggested that the relationship between lifetime smoking and lifetime MD resulted solely from genes that predispose to both conditions. These results suggest that the association between smoking and MD in women is not a causal one but arises largely from familial factors, which are probably genetic, that predispose to both smoking and MD.