The Relationship Between Smoking And Depressive Symptoms And Neuro-cognitive Function In Untreated Depressive Patients

Background:Depressive disorder is the most common mental disorder in adults,children and adolescents.It is the general name of a kind of disease.The main symptoms are mood or depression for at least 2 weeks,accompanied by different degrees of physical symptoms and cognitive changes.It is the second largest source of disease burden after cardiovascular disease.It has the characteristics of high prevalence,recurrence rate,morbidity and suicide rate.Smoking is one of the main causes of preventable death in the world.Smoking is not only a social maladjustment behavior,but also a substance addiction behavior.However,the effect of smoking on depressive disorder is still controversial,so this experiment included untreated patients with depressive disorder into the scope of the study,mainly to analyze and observe the possible relationship between smoking and depressive symptoms and neuro-cognitive function.Objective:The differences of demographic data,depressive symptoms and neuro-cognitive function between smokers and nonsmokers in untreated patients with depressive disorder were compared.And to explore the relationship between tobacco intake and depressive symptoms and neuro-cognitive function in patients with smoking behavior and depressive disorder.Methods:221 patients with depression who were included in a large-scale tertiary first class psychiatric hospital in Guangzhou who had not received corresponding treatment in the past were included in the outpatient department of psychiatry in 2017-2020.The patients were divided into 50 smoking groups and 161 non-smoking groups according to their smoking status.The patients’ smoking status was investigated by the fagerstrfm test for nicotin dependence(FTND).17 Hamilton Depression Rating Scale(HAMD-17)and his 5 subscale(insomnia factor,weight factor,anxiety somatization factor,cognitive impairment factor)were used,The patients’ neuro-cognitive function was tested by using the marcs consensus cognitive battery(MCCB)(the content mainly includes category fluency test,CF,Brief Assessment of Cognition In Schizophrenia Symbol Coding,BACS SC,Trail Making Test A,TMTA,Brief Visuospatial Memory Test-Revised,BVMT-R,Spatial Span,SS,Hopkins Verbal Learning Test-Revised,HVLT-R)is used to determine.The statistical data,depression symptoms and neuro-cognitive function between the two groups were analyzed and compared by using classic statistical methods such as chi square test,Wilcoxon rank sum test and independent sample t test.In the smoking group,the relationship between smoking factors and depression symptoms and neuro-cognitive function was analyzed by using partial correlation analysis method by controlling the variables of education,age,sex and course of disease;The relationship between smoking and depression and neuro-cognitive function was analyzed by multiple linear regression analysis.Results:Compared with the non-smoking group,the smoking group had a relatively higher HAMD-17 score(P<0.05),while the smoking group had lower BACS SC and HVLT-R scores(all P<0.01),and the TMTA score was higher than that of the non-smoking group(P<0.01).BACS SC in the neurocognitive function of the smoking group was negatively correlated with smoking age(r=-0.388,P=0.006)and was negatively correlated with daily smoking(r=-0.294,P=0.045),a retardation factor in depressive symptoms It was positively correlated with daily smoking(r=0.414,P=0.004).Multivariate linear regression analysis showed that daily smoking is the risk factor affecting the retardation factor(P=0.442,P=0.001);smoking age is which affects neuro-cognitive function,the BACS SC(β=-0.593,P<0.01),TMTA(p=0.351,P=0.013),HVLT-R(β=-0.439,P=0.001),BVMT-R(β=-0.349,P=0.013)risk factors.Conclusion:Compared with non-smoking patients with depressive disorder,smoking patients with depressive disorder have more severe depressive symptoms and more obvious neuro-cognitive impairment,which indicates that smoking may be a potential risk factor for aggravating depressive symptoms and neuro-cognitive impairment in patients with depressive disorder.This suggests that more attention should be paid to the depressive symptoms and neuro-cognitive impairment of smoking patients with depressive disorder.