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Date: January 26, 1998
Contact: Doug Fizel
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WHICH SMOKERS USE CIGARETTES TO "SELF-MEDICATE" FOR DEPRESSION MAY DEPEND ON THEIR GENETIC MAKE-UP, NEW STUDY FINDS

Finding Has Implications for Future Treatment of Depressed Smokers

WASHINGTON -- Behavioral research has established that
cigarette smoking by people with depression can be a form of self-
medication, using the mood-altering properties of nicotine to
relieve -- at least temporarily -- depressive symptoms. New
research, appearing in the January edition of the journal Health
Psychology, published by the American Psychological Association
(APA), suggests that depressed people --and nondepressed people --
who smoke to improve their mood may do so because of differences in
their genetic make-up, differences that may be important to the
effectiveness of future treatments for depression and nicotine
dependency.

In their article "Depression and Self-Medication with
Nicotine: The Modifying Influence of the Dopamine D4 Receptor
Gene," psychologist Caryn Lerman, Ph.D., of the Georgetown
University Medical Center, and her co-authors note that previous
research has shown that people with a history of depression are
significantly more likely to be smokers and be diagnosed as
nicotine-dependent. Additionally, smokers are more likely than
nonsmokers to report depressive symptoms and such symptoms predict
relapse following attempts to quit smoking. "In fact," they point
out, "the likelihood of quitting smoking is about 40 percent lower
among depressed smokers compared with the likelihood among
nondepressed smokers." The researchers' study was designed to
determine if genes involved in the brain's reward mechanisms play
a role in this phenomenon.

The researchers recruited 231 smokers who donated blood for
genetic analysis and who were assessed for depressive symptoms,
their level of nicotine dependence and the degree to which they
smoked for stimulation or to counter negative affect (feeling down
in the dumps). This has been referred to as "self-medication"
smoking. A majority of the smokers (63 percent) were classified as
nondepressed and 37 percent were classified as depressed.

The investigators were interested in one particular gene, the
dopamine receptor D4 gene (DRD4) which is highly expressed in the
areas of the brain involved in emotion and reward-seeking
behaviors. The DRD4 gene comes in two forms: short and long. A
given individual can have one form (S/S, L/L) or both (S/L). Among
the study participants, 76 percent had S/S genotypes, 19 percent
has S/L genotypes and only five percent had L/L genotypes.

After analyzing their data, the researchers found
relationships among genotype, the presence or absence of depression
and smoking behaviors: among depressed smokers, those with S/S
genotypes were more likely to smoke for self-medicating purposes
than those with either S/L or L/L genotypes.

Since depressed people appear to be predisposed to initiate
smoking and to become highly nicotine-dependent, the authors
suggest that smokers who report depression may, therefore, "derive
significant benefit from nicotine replacement therapies and
psychotropic medications." With additional research, they add,
"genotyping may become a useful strategy for designing and
targeting pharmacologic therapies to subgroups of depressed smokers
most likely to benefit from them."

Article: "Depression and Self-Medication with Nicotine: The
Modifying Influence of the Dopamine D4 Receptor Gene" by Caryn
Lerman, Ph.D., Georgetown University Medical Center; Neil Caporaso,
MD, National Cancer Institute; David Main, MS, and Janet Audrain,
Ph.D., Georgetown University Medical Center; Neal R. Boyd, Ph.D.,
Fox Chase Cancer Center; Elise D. Bowman, MS, and Peter G. Shields,
MD, National Cancer Institute, in Health Psychology, Vol. 17, No.
1.

(Full text available from the APA Public Affairs Office:
[email protected])

(Caryn Lerman, Ph.D., can be reached through Sue Lin Chong in the
Georgetown University Public Affairs Office at (202) 687-5713 or at
[email protected])

The American Psychological Association (APA), in Washington,
DC, is the largest scientific and professional organization
representing psychology in the United States and is the world's
largest association of psychologists. APA's membership includes
more than 151,000 researchers, educators, clinicians, consultants
and students. Through its divisions in 50 subfields of psychology
and affiliations with 58 state, territorial and Canadian provincial
associations, APA works to advance psychology as a science, as a
profession and as a means of promoting human welfare.

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