Psychosocial and psychiatric-related stress and cigarette smoking among Black and Latinx adults with psychiatric disorders.

While the cigarette smoking prevalence in the United States has decreased, smoking disparities persist for individuals with psychiatric disorders and individuals who identify as racial/ethnic minorities. These groups also experience higher levels of psychosocial stress. This study was the first to examine the relationship between psychosocial and psychiatric-related stressors and cigarette smoking status in a sample of Black and Latinx adults with psychiatric illness. Stress associated with friend strain, lifetime discrimination, and attending appointments for psychotropic medication management were associated with cigarette smoking. The present results have implications for integrating smoking cessation interventions into mental health treatment settings.

Depression and cigarette smoking behavior: A critical review of population-based studies.

BACKGROUND: Smoking and depression are both leading causes of disability, mortality and morbidity around the world. Using epidemiologic data to study the association between depression and the severity, course, and persistence of smoking in the general population is important for understanding the scope of the problem of smoking among people with depression. OBJECTIVES: The current paper aims to critically review existing epidemiologic research on the smoking behaviors of persons with depressive symptoms and disorders and to identify gaps in the literature that warrant further study. METHODS: Literature searches of Medline and EMBASE were used to identify articles that analyzed epidemiologic data and examined an aspect of smoking behavior in persons with depressive symptoms or disorders. Six hundred ninety-three abstracts were reviewed and 45 studies met all of the inclusion criteria to be included in the review. RESULTS: Persons with depression, compared to those without depression, are more likely to smoke, and meet criteria for nicotine dependence, are less likely to quit smoking, and are more likely to relapse. Little is known about the association between depression and smoking behavior by age, socioeconomic status, or race/ethnicity or with regard to the use of tobacco products other than cigarettes. CONCLUSION: Persons with depression are more likely to smoke cigarettes and have greater difficulty quitting smoking. Community-based and public health approaches may need to begin considering the links between depression and smoking in order to best target the current smokers in the population and develop more effective tobacco control campaigns.

Detecting and Predicting Cognitive Decline in Individuals with Traumatic Brain Injury: A Longitudinal Telephone-Based Study.

Traumatic brain injuries (TBIs) can lead to long-lasting cognitive impairments, and some survivors experience cognitive decline post-recovery. Early detection of decline is important for care planning, and understanding risk factors for decline can elucidate targets for prevention. While neuropsychological testing is the gold standard approach to characterizing cognitive function, there is a need for brief, scalable tools that are capable of detecting clinically significant changes in post-TBI cognition. This study examines whether a clinically significant change can be detected using the Brief Test of Adult Cognition by Telephone (BTACT) in a sample of individuals with chronic TBI and investigates whether potentially modifiable factors are associated with cognitive decline. Ninety participants aged 40 or older with complicated mild-to-severe TBI participated in two telephone-based study visits ∼1 year apart. Demographic, head trauma exposure, comorbid medical conditions, physical, and psychosocial functioning data were collected via self-report. The BTACT, a brief measure of global cognitive function, was used to assess cognitive performance across six domains. A reliable change index for quantifying clinically significant changes in BTACT performance was calculated. Results revealed cognitive decline in 10-27% of participants across various cognitive domains. More specifically, only depressive symptoms, including depressed affect and anhedonia, were significantly associated with cognitive decline after correcting for multiple comparisons using false discovery rate (FDR). Other factors such as the number of blows to the head, male gender, dyspnea, increased anxiety symptoms, seizures, illicit drug use, and fewer cardiovascular comorbidities should be considered hypothesis generating. Importantly, age was not a significant predictor of cognitive decline, which challenges the assumption that cognitive decline is solely related to the natural aging process. It suggests that there are unique factors associated with TBI that impact cognitive function, and these factors can affect individuals across the lifespan. The BTACT is a brief and sensitive tool for identifying clinically meaningful changes in cognitive function over a relatively brief period (i.e., 1 year) in a sample of individuals in the chronic stages of TBI (i.e., x̄ = 6.7 years post-TBI). Thus, the BTACT may be useful in surveillance efforts aimed at understanding and detecting decline, particularly in situations where in-person cognitive screening is impractical or unfeasible. We also identified potentially modifiable targets for the prevention of post-TBI cognitive decline. These findings can offer insights into treatment goals and preventive strategies for individuals at risk for cognitive decline, as well as help to facilitate early identification efforts.