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Reply: Depression, Smoking, and Health Status
- Kenneth E. Covinsky, MD, MPH; and
- C. Seth Landefeld, MD
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IN RESPONSE:
Dr. Jay raises the question of whether smoking status confounds the relation we observed between symptoms of depression and poor health status outcomes in acutely ill hospitalized older persons. This is an important question, given evidence that the rates of cigarette smoking may be higher in persons with depression [1, 2]. However, we believe it unlikely that smoking status explains the adverse health outcomes we observed in depressed patients. Previous studies have found that smokers have a 30% to 50% greater risk for clinically significant symptoms of depression [1, 2]. Because we found that patients with many symptoms of depression had a two- to threefold greater risk for adverse health outcomes than patients with few symptoms, it is unlikely that a potentially higher smoking rate in the more depressed patients would account for these differences in health outcomes. Nonetheless, we agree with Dr. Jay's conclusion that future studies of the relation between depression and health status outcomes in older persons should control for the potential confounding effects of smoking.
Kenneth E. Covinsky, MD, MPH
C. Seth Landefeld, MD
Case Western Reserve University School of Medicine; Cleveland, OH 44106-4961
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
