Qiang He, Shengjing Hospital of China Medical University
Lei Yang, Zhengzhou University
Shenxun Shi, Shanghai Jiao Tong University
Jingfang Gao, Chinese Traditional Hospital of Zhejiang
Ming Tao, Xinhua Hospital of Zhejiang Province
Kerang Zhang, Hospital of Shanxi Medical University
Chengge Gao, Hospital of Medical College of Xian Jiaotong University
Lijun Yang, Jilin Brain Hospital
Kan Li, Mental Hospital of Jiangxi Province
Jianguo Shi, Xian Mental Health Center
Gang Wang, Capital Medical University
Lanfen Liu, Shandong Mental Health Center
Jinbei Zhang, Sun Yat-sen University
Bo Du, Hebei Mental Health Center
Guoqing Jiang, Chongqing Mental Health Center
Jianhua Shen, Tianjin Anding Hospital
Zhen Zhang, Jiangsu University
Wei Liang, Psychiatric Hospital of Henan Province
Jing Sun, Nanjing Brain Hospital
Jian Hu, Harbin Medical University
Tiebang Liu, Shenzhen Kangning Hospital
Xueyi Wang, The First Hospital of Hebei Medical University
Guodong Miao, Guangzhou Brain Hospital Guangzhou
Huaqing Meng, Hospital of Chongqing Medical University
Yi Li, Dalian No. 7 Hospital
Chunmei Hu, Bo. 3 Hospital of Heilongjiang Province
Yi Li, Wuhan Mental Health Center
Guoping Huang, Sichuan Mental Health Center
Gongying Li, Mental Health Institute of Jining Medical College
Baowei Ha, Liaocheng No. 4 Hospital
Hong Deng, Mental Health Center of West China Hospital of Sichuan University
Qiyi Mei, Suzhou Guangji Hospital
Hui Zhong, Anhui Mental Health Center
Shugui Gao, Ningbo Kang Ning Hospital
Hong Sang, Changchun Mental Hospital
Yutang Zhang, No. 2 Hospital of Lanzhou University
Xiang Fang, Fuzhou Psychiatric Hospital
Fengyu Yu, Harbin No. 1 Special Hospital
Donglin Yang, Jining Psychiatric Hospital
Tieqiao Liu, No. 2 Xiangya Hospital of Zhongnan University
Yunchun Chen, Xijing Hospital of No. 4 Military Medical University
Xiaohong Hong, Mental Health Center of Shantou University
Wenyuan Wu, Tongji University Hospital
Guibing Chen, Huaian No. 3 Hospital
Min Cai, Huzhou No. 3 Hospital
Yan Song, Mudanjiang Psychiatric Hospital of Heilongjiang Province
Jiyang Pan, No. 1 Hospital of Jinan University
Jicheng Dong, Qingdao Mental Health Center
Runde Pan, Guangxi Longquanshan Hospital
Wei Zhang, Daqing No. 3 Hospital of Heilongjiang Province
Zhenming Shen, Tangshan No. 5 Hospital
Zhengrong Liu, Anshan Psychiatric Rehabilitation Hospital
Danhua Gu, Weihai Mental Health Center
Xiaoping Wang, Renmin Hospital of Wuhan University
Ying Liu, The First Hospital of China Medical University
Xiaojuan Liu, Tianjin First Center Hospital
Qiwen Zhang, Hainan Anning Hospital
Yihan Li, Wellcome Trust Centre for Human Genetics
Yiping Chen, Clinical Trial Service Unit
Kenneth S. Kendler, Virginia Commonwealth UniversityFollow
Xumei Wang, ShengJing Hospital of China Medical University
Youhui Li, Hospital of Zhengzhou University
Jonathan Flint, Wellcome Trust Centre for Human Genetics

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November 2014



To investigate the risk factors that contribute to smoking in female patients with major depressive disorder (MDD) and the clinical features in depressed smokers.


We examined the smoking status and clinical features in 6120 Han Chinese women with MDD (DSM-IV) between 30 and 60 years of age across China. Logistic regression was used to determine the association between clinical features of MDD and smoking status and between risk factors for MDD and smoking status.


Among the recurrent MDD patients there were 216(3.6%) current smokers, 117 (2.0%) former smokers and 333(5.6%) lifetime smokers. Lifetime smokers had a slightly more severe illness, characterized by more episodes, longer duration, more comorbid illness (panic and phobias), with more DSM-IV A criteria and reported more symptoms of fatigue and suicidal ideation or attempts than never smokers. Some known risk factors for MDD were also differentially represented among smokers compared to non-smokers. Smokers reported more stressful life events, were more likely to report childhood sexual abuse, had higher levels of neuroticism and an increased rate of familial MDD. Only neuroticism was significantly related to nicotine dependence.


Although depressed women smokers experience more severe illness, smoking rates remain low in MDD patients. Family history of MDD and environmental factors contribute to lifetime smoking in Chinese women, consistent with the hypothesis that the association of smoking and depression may be caused by common underlying factors.


Copyright: © 2014 He et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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VCU Psychiatry Publications