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This Week in Psychiatry — 1/10/11

January 7, 2011

Quitting Smoking and Depression: Estimated Prevalence Rates

Depressed smokers who are attempting to quit have higher rates of depression and lower rates of quitting when compared to non-depressed smokers attempting to quit. Researchers recently found that ~24% of smokers who called the California Smokers’ Helpline in 2007 had MDD and ~17% had mild depression. At 2-month follow-up ~56% of MDD callers had attempted to quit, compared to ~64% of mild depression callers. Approximately 18.5% of MDD callers quit and 31.4% mild depression callers quit. These patients could benefit from an integrated health care model treating the depression and smoking cessation simultaneously, thus allowing one physician to treat both conditions.

Is Altitude A Suicide Predictor?

The authors of a recent American Journal of Psychiatry study investigated a hypothetical link between altitude in the western mountain ranges of the US and suicide rates. That is, higher altitudes in this region are likely to have lower population densities and more gun ownership. The investigators found a correlation between county elevation and age adjusted firearm-related (r=.41) and non–firearm-related (r=.32) suicide rates. This correlation may perhaps be attributed to metabolic stress from mild hypoxia in individuals with mood disorders, the authors say.

Mindfulness Therapy, Depression: Preventing Relapse

A trained self-awareness for signs of depression relapse may be effective for long-term maintenance, according to an Archives of General Psychiatry study. Patients with ≥2 previous depressive episodes and currently in remission (n=84; 52.5% of study sample) were assigned to one of the following: (1) antidepressant discontinuation and 8 weekly sessions of mindfulness-based cognitive therapy (MBCT), designed to improve self-recognition and self-management of prodromal symptoms of depression relapse; (2) antidepressant maintenance; (3) or placebo. Unstable remitters in the MBCT and antidepressant maintenance groups had a 73% decrease in hazard for relapse compared to placebo (P=.03). There were no group differences for stable remitters.

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