BACKGROUND Comorbid psychiatric diagnoses have been shown to predict cessation failure. The relative impact of various diagnoses on cessation and other cessation processes is rarely studied, particularly among a general population. The impact of psychiatric history among primary care patients seeking cessation services on nicotine dependence, cessation outcomes, treatment effects and adherence, and withdrawal symptoms was examined. METHODS Secondary data analysis of a multi-site comparative effectiveness smoking cessation trial was conducted. Adult smokers (n  = 1051; 52.5 % Female, 68.1 % white) completed a structured clinical interview at baseline to assess psychiatric diagnostic history (past-year and lifetime). Nicotine dependence was assessed via self-report measures at baseline. Point-prevalence abstinence was assessed at 8 weeks and 6 months post-quit. Withdrawal symptoms were assessed for one week pre- and post-quit using ecological momentary assessment. Treatment adherence was self-reported at 1, 4, 8, and 12 weeks post-quit. RESULTS Past-year substance use disorder, lifetime mood disorder, and > one lifetime diagnosis, were related to lower rates of short-term, but not long-term, cessation. Lifetime psychiatric diagnosis was related to elevated nicotine dependence, particularly to secondary dependence motives associated with instrumental tobacco use. History of psychiatric diagnosis was associated with increased withdrawal-related craving. There was little evidence that psychiatric diagnostic status moderated the effects of the tested pharmacotherapies on long-term abstinence. CONCLUSIONS Psychiatric diagnoses affect risk factors that exert their effects early in the post-quit process and highlight the potential utility of examining transdiagnostic risk factors to better understand the relations between psychiatric vulnerabilities and the smoking cessation process.

中文翻译：

---

一项比较有效性的戒烟试验中的精神病合并症：与戒烟成功率，治疗反应和复发风险因素的关系。

背景技术已显示出共病的精神病学诊断可预测戒断失败。很少研究各种诊断对戒烟和其他戒烟过程的相对影响，尤其是在普通人群中。在寻求戒烟服务的初级保健患者中，精神病史对尼古丁依赖，戒烟结局，治疗效果和依从性以及戒断症状的影响得到了检查。方法进行了一项多站点比较有效性戒烟试验的二级数据分析。成年吸烟者（n = 1051； 52.5％的女性，68.1％的白人）在基线完成了结构化的临床访谈，以评估精神病学诊断史（过去和终生）。尼古丁依赖性通过基线时的自我报告测量进行评估。戒烟后8周和6个月评估了点流行率的戒断。戒断前和戒断后一周的戒断症状使用生态瞬时评估进行评估。退出后1、4、8和12周自我报告治疗依从性。结果过去一年的物质使用障碍，一生的情绪障碍和一生以上的诊断与短期（而非长期）戒断发生率降低相关。终生精神病学诊断与尼古丁依赖增加有关，特别是与工具烟草使用相关的继发性依赖动机有关。精神病诊断史与戒断相关的渴望增加有关。几乎没有证据表明精神病学诊断状态可以减轻测试药物治疗对长期禁欲的影响。