哮喘联盟

   摘要
   目的：比较戒烟后与继续吸烟的心理健康变化。
   方法：对观察性研究进行系统综述和meta分析。
   数据来源：从开始到2012年4月Web of Science、Cochrane图书馆注册对照研究、Medline, Embase和PsycINFO收录的相关研究。入选研究的参考目录为手动搜索，如果数据报道不完整，可联系作者。
   所选研究的纳入标准：对健康成人或成年患者戒烟前和至少戒烟6周后或基线的心理健康进行评估的纵向研究。
   结果：共26项通过问卷评估心理健康的调查纳入本研究，问卷评估内容包括焦虑、沮丧、混合性焦虑和沮丧、心理生活质量、正面情绪和压力。基线检测后7周～9年期间，随访心理健康评分。基线和随访期间，戒烟者的焦虑、沮丧、混合性焦虑和沮丧及压力明显低于继续吸烟者：标准差（95%可信区间）为：焦虑 -0.37（95%可信区间为-0.70 ～ -0.03）；沮丧 -0.25 (-0.37 ～ -0.12)；混合性焦虑和沮丧 -0.31 (-0.47 ～ -0.14)；紧张 -0.27 (-0.40 ～ -0.13)。基线和随访期间，戒烟者的心理生活质量（0.22 ，0.09 ～ 0.36)和正面情绪（0.40, 0.09 ～ 0.71）均显著高于继续吸烟者。无证据显示此效应值在普通人群和身体或精神障碍人群中有差异。
   结论：与继续吸烟相比，戒烟能降低抑郁、焦虑和压力，并可增加正面情绪、提高生活质量。此效益值在精神障碍者和正常人中一样大。而对于因情绪或焦虑障碍接受抗抑郁治疗的患者，此效应值可能相同或略小。
 

（刘国梁 审校）
BMJ. 2014 Feb 13;348:g1151. doi: 10.1136/bmj.g1151.

 

Change in mental health after smoking cessation: systematic review and meta-analysis.
 

Taylor G, McNeill A, Girling A, Farley A, Lindson-Hawley N, Aveyard P.
 

Abstract
OBJECTIVE: To investigate change in mental health after smoking cessation compared with continuing to smoke.
DESIGN: Systematic review and meta-analysis of observational studies.
DATA SOURCES: Web of Science, Cochrane Central Register of Controlled Trials, Medline, Embase, and PsycINFO for relevant studies from inception to April 2012. Reference lists of included studies were hand searched, and authors were contacted when insufficient data were reported.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Longitudinal studies of adults that assessed mental health before smoking cessation and at least six weeks after cessation or baseline in healthy and clinical populations.
RESULTS: 26 studies that assessed mental health with questionnaires designed to measure anxiety, depression, mixed anxiety and depression, psychological quality of life, positive affect, and stress were included. Follow-up mental health scores were measured between seven weeks and nine years after baseline. Anxiety, depression, mixed anxiety and depression, and stress significantly decreased between baseline and follow-up in quitters compared with continuing smokers: the standardised mean differences (95% confidence intervals) were anxiety -0.37 (95% confidence interval -0.70 to -0.03); depression -0.25 (-0.37 to -0.12); mixed anxiety and depression -0.31 (-0.47 to -0.14); stress -0.27 (-0.40 to -0.13). Both psychological quality of life and positive affect significantly increased between baseline and follow-up in quitters compared with continuing smokers 0.22 (0.09 to 0.36) and 0.40 (0.09 to 0.71), respectively). There was no evidence that the effect size differed between the general population and populations with physical or psychiatric disorders.
CONCLUSIONS: Smoking cessation is associated with reduced depression, anxiety, and stress and improved positive mood and quality of life compared with continuing to smoke. The effect size seems as large for those with psychiatric disorders as those without. The effect sizes are equal or larger than those of antidepressant treatment for mood and anxiety disorders.
 

BMJ. 2014 Feb 13;348:g1151. doi: 10.1136/bmj.g1151.