Effectiveness of cognitive-behavioral therapy for smokers with histories of alcohol dependence and depression
Effectiveness of cognitive-behavioral therapy for smokers with histories of alcohol dependence and depression
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DOI：
10.15288/jsa.1998.59.327
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发表时间：
1998-05-01
期刊：
影响因子：
--
通讯作者：
Williams, CD
中科院分区：
文献类型：
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作者：
Patten, CA;Martin, JE;Williams, CD
目的：酒精依赖和重度抑郁症与重度吸烟和不良吸烟治疗结果相关。本初步研究考察了情绪管理干预对有重度抑郁症病史的戒酒者戒烟的效果。方法：29名重度吸烟者（15名女性，14名男性）（平均30.2支/天），平均持续戒酒6.8年，随机分为行为咨询（BC）组（n = 16）或行为咨询+认知行为情绪管理（CBT）组（n = 13）。采用2 × 5重复测量设计评估干预措施在基线、治疗后以及1、3和12个月随访时对吸烟结局的有效性。用生化（COa）和举报人报告验证自我报告的吸烟状况。结果：经验证的自我报告显示，CBT组戒烟者（69.2%，13人中有9人）明显多于BC组（31.3%，16人中有5人）（chi(2) = 4.14, 1 df, p = 0.04）。这些戒断率在1个月的随访中保持不变。在3个月的随访中，CBT（46.2%， 13例中有6例）和BC（25.0%， 16例中有4例）的戒烟率差异不显著。然而，在12个月的随访中，CBT组戒烟的参与者（46.2%，13人中有6人）明显多于BC组（12.5%，16人中有2人）（chi(2) = 4.07, 1 df, p = 0.04）。结论：研究结果表明，专注于控制消极情绪的干预措施可能有利于这些高风险的共病吸烟者。
Objective: Alcohol dependence and major depression have been associated with heavy cigarette use and poor smoking-treatment outcomes. This preliminary study examined the efficacy of a mood management intervention for smoking cessation in abstinent alcoholics with a history of major depression. Method: Participants were 29 (15 female, 14 male) heavy smokers (mean cigs/day = 30.2), with an average of 6.8 years of continuous abstinence from alcohol and drugs, randomized to behavioral counseling (BC) (n = 16) or behavioral counseling + cognitive-behavioral mood management (CBT) (n = 13). A 2 x 5 repeated measures design was used to evaluate the effectiveness of the interventions on smoking outcome at baseline, posttreatment and at 1-, 3- and 12-month-follow-up. Self-reported smoking status was verified with biochemical (COa) and informant report. Results: Verified self-report indicated that significantly more smokers in CBT quit by posttreatment (69.2%; 9 of 13) than in BC (31.3%; 5 of 16) (chi(2) = 4.14, 1 df, p = .04). These abstinence rates remained unchanged at 1-month follow-up. At 3-month follow-up, differences in smoking abstinence rates were nonsignificant between CBT (46.2%; 6 of 13) and BC (25.0%; 4 of 16) conditions. However, at 12-month follow-up, significantly more participants in CBT were abstinent from smoking (46.2%; 6 of 13) than in BC (12.5%; 2 of 16) (chi(2) = 4.07, 1 df, p = .04). Conclusions: The results suggest that interventions focused on managing negative mood may benefit these high-risk, comorbid smokers.