Clipping of news on Brazilian Culture, Law and Citizenship
Source: Agência FAPESP 7/10/2009
This article was translated by an automatic translation system, and was therefore not reviewed by people.
Agency FAPESP - Depression is a factor of recidivism for ex-smokers who were hospitalized after suffering myocardial infarction or unstable angina. It is what completes a survey, conducted at the Federal University of São Paulo (UNIFESP) in partnership with the Heart Institute (InCor), Hospital das Clinicas, Faculty of Medicine, University of São Paulo (USP).
The study aimed to investigate, among hospitalized patients diagnosed with acute coronary syndromes, with depression and other features are factors that can predict the extent to which patients maintain abstinence from nicotine initiated during hospitalization. The survey also assessed factors associated with nicotine dependence, like alcohol and caffeine, and risk perception.
The paper, entitled "Factors associated with and predictive of relapse to smoking behavior in patients with acute coronary syndromes," the result is a doctoral psychologist Glória Heloise Perez, defended at UNIFESP. The author is chief psychologist at InCor.
The study was based on a survey started nearly 10 years by Ronaldo Ramos Laranjeira, professor, Department of Psychiatry, UNIFESP, supported by FAPESP in the mode of research assistance. Thesis advisor of Gloria, Laranjeira said the study is innovative, even if the subject has begun to be explored for nearly a decade.
"Today the literature to corroborate these associations between the difficulty of quitting smoking and the occurrence of depression, or other factors. But ten years ago, when we present a project to FAPESP, the subject was very little reviewed, "said Laranjeira Agency FAPESP.
The researcher is coordinator of the thematic project titled "National Institute of Public Policies on Alcohol and other drugs", financed by FAPESP. He said the study presented by Gloria draws attention to the need to give more assistance to smokers, especially those who can not stop smoking.
"It does no good to tell a person who has suffered heart attack, now that was sick, need to stop smoking. Without structure and treatment, which also involves use of medications, many return to smoking, "says Laranjeira.
The element of "innovative" work of glory was to take account of psychological issues, such as depression, according Laranjeira. "It is natural that these questions of a psychological also interfere with the process of stopping smoking," said Gloria Agency FAPESP.
The study evaluated 403 patients who had myocardial infarction or unstable angina, monitored for six months after the hospitalization. According to psychologist, depressed patients had proportionally more likely to relapse than non-depressed inpatients.
"When a patient is hospitalized for treatment of heart disease such as heart attacks, for example, is prohibited from smoking. This causes a person from compulsory abstinence, "he explains.
Respondents were, on average, eight days in hospital and therefore were forced to stop smoking during that period. "As they were outside the routine, living a disease with other symptoms, very unwell and out of the habit of conditioning, stay in hospital longer is a factor that protects," said Perez.
The survey found that there was a withdrawal of about 60%, ie, less than half (40%) patients returned to smoking. "This means that the hospital is a great opportunity for people to stop smoking," said the psychologist.
The hospitalization time was considered a factor influencing the relapse of patients: the smaller the length of hospital stay, the greater the chance of relapse, since the "first week is the worst time to resist the temptation to smoke," says researcher .
Having a diagnosis of unstable angina - and not a heart attack - was also considered a factor "predictive," according to the study. The gravity factor would be a "mobilizer" to stop the addiction.
"The patient has the diagnosis of unstable angina think the disease is less severe, so back to smoking. The patient's heart attack not. He knows the seriousness of the disease, which is potentially fatal, "said Gloria.
Factors associated
According to psychologist InCor, the relationship between depression and smoking behavior is very complex. We applied two scales to assess depression. A diagnostic and one for the intensity of the problem.
"It's a two-way street. Both a person may smoke to relieve the symptoms of depression because nicotine has an antidepressant effect, but some studies show that smokers can develop depression, "he says.
Compared with non-smokers, smokers with acute coronary syndrome are younger, more likely to coffee consumption and perceived less smoking as a risk factor for heart disease.
According to the study, male smokers are also more prone to alcohol consumption, indicating that use more psycho-stimulants than male non-smokers and female smokers.
But, according to Gloria, the consumption of alcohol was not a predictor of relapse, but an associated factor. Among men, smokers had a diagnosis of myocardial consume more coffee and alcohol. "Smokers are younger and are sick earlier than nonsmokers," he added.
This article was translated by an automatic translation system, and was therefore not reviewed by people.