Cigarette smoking, nicotine dependence and anxiety disorders: a systematic review of population-based, epidemiological studies

BMC Medicine

Michael Berk¹  Julie A Pasco³  Felice N Jacka⁴  Steven Moylan² 

[1] The Florey Institute for Neuroscience and Mental Health, Parkville, Victoria, Australia;Deakin University School of Medicine, Barwon Health, Geelong, Victoria, Australia;NorthWest Academic Centre, Department of Medicine, The University of Melbourne, St Albans, Victoria, Australia;Department of Psychiatry, Melbourne University, Parkville, Victoria, Australia

关键词: specific phobia;    post-traumatic stress disorder;    panic disorder;    obsessive-compulsive disorder;    nicotine dependence;    generalized anxiety disorder;    epidemiology;    cigarette smoking;    anxiety disorder;    agoraphobia;   

Others  :  857329
DOI  :  10.1186/1741-7015-10-123

 received in 2012-04-30, accepted in 2012-10-19,  发布年份 2012

【 摘 要 】

Background

Multiple studies have demonstrated that rates of smoking and nicotine dependence are increased in individuals with anxiety disorders. However, significant variability exists in the epidemiological literature exploring this relationship, including study design (cross-sectional versus prospective), the population assessed (random sample versus clinical population) and diagnostic instrument utilized.

Methods

We undertook a systematic review of population-based observational studies that utilized recognized structured clinical diagnostic criteria (Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD)) for anxiety disorder diagnosis to investigate the relationship between cigarette smoking, nicotine dependence and anxiety disorders.

Results

In total, 47 studies met the predefined inclusion criteria, with 12 studies providing prospective information and 5 studies providing quasiprospective information. The available evidence suggests that some baseline anxiety disorders are a risk factor for initiation of smoking and nicotine dependence, although the evidence is heterogeneous and many studies did not control for the effect of comorbid substance use disorders. The identified evidence however appeared to more consistently support cigarette smoking and nicotine dependence as being a risk factor for development of some anxiety disorders (for example, panic disorder, generalized anxiety disorder), although these findings were not replicated in all studies. A number of inconsistencies in the literature were identified.

Conclusions

Although many studies have demonstrated increased rates of smoking and nicotine dependence in individuals with anxiety disorders, there is a limited and heterogeneous literature that has prospectively examined this relationship in population studies using validated diagnostic criteria. The most consistent evidence supports smoking and nicotine dependence as increasing the risk of panic disorder and generalized anxiety disorder. The literature assessing anxiety disorders increasing smoking and nicotine dependence is inconsistent. Potential issues with the current literature are discussed and directions for future research are suggested.

【 授权许可】

   
2012 Moylan et al; licensee BioMed Central Ltd.

【 图 表 】

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