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Location: Indiana, United States

I became a Professor Emeritus after serving 29 years as a recreational therapy faculty member at Indiana University. I'm a long-time Hoosier, having grown up in Hanover, Indiana. My RT practitioner work was in psych/mental health. After completing my Ph.D. at the University of Illinois, my first faculty position was at the University of North Texas. RT has been a wonderful profession for me as I have had the opportunity to serve as an author and national leader.

Tuesday, June 05, 2007

Smoking Increases Risk for Depression

From my practitioner days working with clients with problems in mental health, I can recall that many of my clients were smokers. I would anticipate that even today there is a trend among mental health clients to be smokers. If you work with clients who smoke, you may wish to share the results of the following study with them.

An article by Karla Gale of Reuters Health has reviewed research that shows persistent smokers appear to be at increased risk for becoming depressed compared to never smokers.This is according to results of a long-term study of Finnish twins. On the other hand, this association was not seen in individuals who stopped smoking many years ago.

"Although nicotine in cigarettes has some mood-elevating properties, in the long-run chronic exposure to cigarette smoke may have a more important role in the etiology of depressive symptoms," lead author Dr. Tellervo Korhonen from the University of Helsinki told Reuters Health.

The results are based on 4,000 male and 5,000 female Finnish twins, whose health and health behavior were monitored for 15 years. The results suggest that persistent chronic smoking predicts the development of depressive symptoms.

There was also evidence that smokers who had quit were also at increased risk of depression, but only in the short term. Smokers who quit and remained off cigarettes in the long run did not have an increased risk for depression compared with never smokers. "This may reflect a relatively long recovery process from the adverse effects of cigarette smoking," Korhonen said in a statement.

"When people start smoking, the immediate effects of nicotine in the brain are rewarding and pleasurable," Korhonen explained. "This suggests self-medication, where a person who has mood problems seeks relief via cigarette."

Because addiction to nicotine is as strong as an addiction to heroin, abstinence is difficult.

"Smokers who are vulnerable to depression may need specific pharmacological treatment and behavioral support to overcome the earlier phase of abstinence," Korhonen said. After that, "their chances to quit successfully improve."

SOURCE: Psychological Medicine, May 2007.

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