Peer Reviewed

1

Document Type

Article

Publication Date

1-2014

Keywords

Depression, Coronary Heart Disease, Health Behaviors, Smoking, Smoking Cessation

Comments

This is a non-final version of an article published in final form in Psychosomatic Medicine.http://journals.lww.com/psychosomaticmedicine/Abstract/2014/01000/Systematic_Review_and_Meta_Analysis_of_the_Impact.7.aspx

Abstract

Objective:

Smoking cessation is crucial for patients with coronary heart disease (CHD), yet depression may impede cessation success. We systematically reviewed the longitudinal association between depression and subsequent smoking cessation in individuals with CHD in order to quantify this effect.

Methods:

Electronic databases (PsychInfo, PubMed, CINAHL) were searched for prospective studies of CHD patients which measured depression at baseline (scales, diagnostic interview or antidepressant prescription) and reported smoking continuation/cessation at follow-up. Inclusive dates were 1st January 1990 to 22nd May 2013. Standardized mean differences (SMD) and associated 95% confidence interval (CI) were estimated using random effects meta-analysis. Sensitivity analysis explored the impact of limiting meta-analysis to studies using different depression measures (validated scales, diagnostic interviews, antidepressant prescription), different durations of follow-up, or higher quality studies.

Results:

From 1451 citations retrieved, 28 relevant articles were identified. Meta-analysis of all available data from 20 unique datasets found that depressed CHD patients were significantly less likely to quit smoking at follow-up (SMD=-.39, 95% CI -.50 to -.29; I2=51.2%, p=.005). Estimates remained largely unchanged for each sensitivity analysis, except for two studies that used antidepressants, which showed a much larger effect (SMD=-.94, -1.38 to -.51; I2=57.7%, p=.124).

Conclusions:

CHD patients with depressive symptoms are significantly less likely to quit smoking than their non-depressed counterparts. This may have implications for cardiovascular prognosis, and CHD smokers may require aggressive depression treatment to enhance their chances of quitting.

Disciplines

Psychology

Citation

Doyle F, Rohde D, Rutkowska A, Morgan K, Cousins G, McGee H. Systematic review and meta-analysis of the impact of depression on subsequent smoking cessation in patients with coronary heart disease: 1990-2013. Psychosomatic Medicine. 2014;76(1):44-57.

PubMed ID

24367125

DOI Link

10.1097/PSY.0000000000000020

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.

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