Study of Association of Nicotine Dependence and Depression among Medical Outpatients

ABSTRACT

Background: Nicotine dependence and depression have been associated in many studies. The current study aims to determine the association of nicotine dependence and depression, the association of severity of nicotine dependence with depression and the severity of depression in nicotine dependent patients suffering from depression. Methodology: It was an observational, cross sectional, and comparative study. 150 consecutive patients attending medical OPD diagnosed as having nicotine dependence by Diagnostic Statistical Manual (DSM)- 5 were screened by Fagerstrom test, Modified Fagerstrom scale and diagnostic criteria of Major Depressive Disorder using DSM-5. Hamilton Depression (HAM-D) rating scale was applied to patients suffering from depression to know the severity. Statistical analysis was done using z test, Chi square test, Fischer’s exact test and Odds’ ratio. Results: Patients with nicotine dependence were found to have statistically significant higher rate of depression than persons without nicotine dependence. (17.8 % vs 8.6%). It was found more in married patients (52%) and in patients from lower socio-economic class (75%). 72.7% of patients used smokeless forms. Conclusion: Though highly prevalent, tobacco use disorder is often ignored due to absence of behavioral symptoms. Not only there is increase prevalence of depression in nicotine dependent patients, having depression can lead to increased chances of nicotine dependence. Hence addressing nicotine use is essential for better prognosis of both disorders