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The association among depressive symptoms, smoking status and antidepressant use in cardiac outpatients

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Abstract

Both depression and smoking are highly prevalent and related to poorer outcomes in cardiac patients. In this study, the authors examined the association between depressive symptoms and smoking status, described the frequency and type of antidepressant use, and prospectively tested the effects of antidepressant use in smokers on smoking status and psychosocial outcomes. Participants comprised 1,498 coronary artery disease (CAD) outpatients who completed a baseline survey which assessed depressive symptoms, current medications, and smoking status. A second survey was mailed 9 months later that assessed depressive symptoms, anxiety, insomnia and smoking status. Results showed that current and former-smokers had significantly greater depressive symptoms than non-smokers. Ten percent of patients were taking antidepressants, most frequently SSRIs, with significantly more smokers on antidepressants than former and non-smokers. At follow-up, smokers on antidepressants were less likely to have quit, had greater anxiety, depressive symptoms and insomnia than smokers not using antidepressants. This study demonstrated that smokers and quitters with CAD had greater depressive symptoms and use of antidepressants than non-smokers, but that the antidepressants utilized may not be optimizing outcomes.

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Acknowledgments

This research is funded by the Canadian Institutes of Health Research (CIHR), grant # MOP-74431. Dr. S. Grace is supported by CIHR, and S. Gravely-Witte is supported by the Ontario Women’s Health Council/CIHR Institute of Gender and Health. We also acknowledge Sheena Kayaniyil for data entry.

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Authors and Affiliations

  1. Faculty of Health, York University, Norman Bethune 222B, 4700 Keele St, Toronto, ON, M3J 1P3, Canada

    Shannon Gravely-Witte & Sherry L. Grace

  2. Women’s Health Program, University Health Network, Toronto, ON, Canada

    Shannon Gravely-Witte, Donna E. Stewart & Sherry L. Grace

  3. The University of Toronto, Toronto, ON, Canada

    Donna E. Stewart & Sherry L. Grace

  4. London Health Sciences Centre, London, ON, Canada

    Neville Suskin

  5. University of Western Ontario, London, ON, Canada

    Neville Suskin

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  1. Shannon Gravely-Witte
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Correspondence to Shannon Gravely-Witte.

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Gravely-Witte, S., Stewart, D.E., Suskin, N. et al. The association among depressive symptoms, smoking status and antidepressant use in cardiac outpatients. J Behav Med 32, 478–490 (2009). https://doi.org/10.1007/s10865-009-9218-3

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