Patterns of tobacco-related mortality among individuals diagnosed with schizophrenia, bipolar disorder, or depression
Patterns of tobacco-related mortality among individuals diagnosed with schizophrenia, bipolar disorder, or depression
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DOI：
10.1016/j.jpsychires.2013.09.014
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发表时间：
2014-01-01
影响因子：
4.8
通讯作者：
Gatley, Jodi
中科院分区：
文献类型：
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作者：
Callaghan, Russell C.;Veldhuizen, Scott;Gatley, Jodi
尽管精神病患者的吸烟率大约是一般人群的2-4倍，但令人惊讶的是，几乎没有证据可以为评估这些人群中与烟草有关的死亡率提供信息。目前的研究旨在提供1990年至2005年加州因初级精神病诊断住院的个人中与烟草使用有因果关系的疾病的死亡率估计。将病例限制在随访中期35岁或以上的个体，我们将ICD-9诊断为精神分裂症及相关疾病（“精神分裂症”; n = 174，277）、抑郁症（n = 338，250）或双相情感障碍（n = 78，739）的个体组成队列。住院记录与死亡证明数据相关联。我们为疾病控制和预防中心确定的19种与烟草使用有因果关系的疾病生成了年龄，性别和种族调整的标准化死亡率（SMR）。所有烟草相关疾病合并的SMR为：精神分裂症，2.45（95% CI = 2.41-2.48）;双相情感障碍，1.57（95% CI = 1.53-1.62）;抑郁症，1.95（95% CI = 1.93-1.98）。烟草相关疾病约占精神分裂症总死亡人数的53%（23，620/44，469），双相情感障碍患者的48%（6004/12，564）和抑郁症队列的50%（35，729/71，058）。解决精神病人群的烟草使用问题是一个重要的临床和公共卫生问题，特别是考虑到目前对这些群体烟草使用的临床关注有限。(C)2013爱思唯尔有限公司保留所有权利。
Even though individuals with psychiatric conditions have a prevalence of smoking approximately 2-4 times greater than the general population, surprisingly little evidence exists to inform an assessment of the full range of tobacco-related mortality in such populations. The current study aims to provide mortality estimates for conditions causally related to tobacco use among individuals hospitalized with a primary psychiatric diagnosis in California from 1990 to 2005. Restricting cases to those of individuals aged 35 or older at the mid-point of their follow-up period, we assembled cohorts of individuals with ICD-9 diagnoses of schizophrenia and related disorders ("schizophrenia"; n = 174,277), depressive disorders (n = 338,250), or bipolar disorder (n = 78,739). Inpatient records were linked to death-certificate data. We generated age-, sex-, and race-adjusted standardized mortality ratios (SMRs) for the 19 diseases identified by the Centers for Disease Control and Prevention as being causally linked to tobacco use. The SMRs for all tobacco-linked diseases combined were: schizophrenia, 2.45 (95% CI = 2.41-2.48); bipolar, 1.57 (95% CI = 1.53-1.62); and depression, 1.95 (95% CI = 1.93-1.98). Tobacco-related conditions comprised approximately 53% (23,620/44,469) of total deaths in the schizophrenia, 48% (6004/12,564) in the bipolar, and 50% (35,729/71,058) in the depression cohorts. Addressing tobacco use in psychiatric populations is a critical clinical and public-health concern, especially in light of the currently limited clinical attention devoted to tobacco use in these groups. (C) 2013 Elsevier Ltd. All rights reserved.