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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Systematic review and meta-analysis of the impact of depression on subsequent smoking cessation in patients with coronary heart disease: 1990 to 2013
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Systematic review and meta-analysis of the impact of depression on subsequent smoking cessation in patients with coronary heart disease: 1990 to 2013

机译：1990年至2013年抑郁对冠心病患者随后戒烟的影响的系统评价和荟萃分析

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Objective: Smoking cessation is crucial for patients with coronary heart disease (CHD), yet depression may impede cessation success. We systematically reviewed the prospective association between depression and subsequent smoking cessation in individuals with CHD to quantify this effect. Methods: electronic databases (PsychInfo, PubMed, CINAHL) were searched for prospective studies of patients with CHD that measured depression at baseline (scales, diagnostic interview, or antidepressant prescription) and reported smoking continuation/cessation at follow-up. Inclusive dates were January 1, 1990, to May 22, 2013. Standardized mean differences (SMDs) and associated 95% confidence intervals 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 1185 citations retrieved, 28 relevant articles were identified. Meta-analysis of all available data from 20 unique data sets found that depressed patients with CHD were significantly less likely to quit smoking at follow-up (SMD =-0.39, 95% confidence interval =-0.50 to-0.29; 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 =-0.94,-1.38 to-0.51; I2 = 57.7%, p =.124). Conclusions: Patients with CHD and depressive symptoms are significantly less likely to quit smoking than their nondepressed counterparts. This may have implications for cardiovascular prognosis, and CHD smokers may require aggressive depression treatment to enhance their chances of quitting.
机译：目的：戒烟对冠心病（CHD）患者至关重要，而抑郁症可能会阻碍戒烟成功。我们系统地回顾了冠心病患者抑郁与随后戒烟之间的前瞻性关联，以量化这种影响。方法：在电子数据库（PsychInfo，PubMed，CINAHL）中搜索对冠心病患者的前瞻性研究，这些患者在基线时测量抑郁（量表，诊断性访谈或抗抑郁药处方），并在随访中报告吸烟持续/停止。纳入日期为1990年1月1日至2013年5月22日。使用随机效应荟萃分析估算标准均值差（SMD）和相关的95％置信区间。敏感性分析探讨了限制荟萃分析对使用不同抑郁测量方法（有效量表，诊断性访谈，抗抑郁药的处方），随访时间不同或研究质量较高的研究的影响。结果：从1185篇文献中检索到28篇相关文章。对来自20个独特数据集的所有可用数据进行的荟萃分析发现，抑郁的CHD患者在随访时戒烟的可能性大大降低（SMD = -0.39，95％置信区间= -0.50至-0.29; I2 = 51.2％ ，p = .005）。除了两项使用抗抑郁药的研究显示出更大的效果（SMD = -0.94，-1.38至-0.51; I2 = 57.7％，p = .124）外，每次敏感性分析的估计值基本上保持不变。结论：冠心病和抑郁症状的患者戒烟的可能性明显低于非抑郁症患者。这可能对心血管疾病的预后有影响，冠心病吸烟者可能需要积极的抑郁症治疗，以增加戒烟的机会。

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