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  • Title: Increasing diagnosis of nicotine dependence in adolescent mental health patients.
    Author: Sellman JD, Wootton AR, Stoner DB, Deering DE, Craig BJ.
    Journal: Aust N Z J Psychiatry; 1999 Dec; 33(6):869-73. PubMed ID: 10619214.
    Abstract:
    OBJECTIVE: The aim of this study was to investigate the routine recording patterns of patients' smoking by clinical staff of an adolescent mental health service over a 3-year period. METHOD: A systematic examination of the clinical files of all patients who underwent an initial assessment or reassessment at the Youth Specialty Service (Mental Health; YSS) over a 2-month period (1 April-31 May) was carried out in 1996, 1997 and 1998. A range of data were collected including: demographics; diagnoses; amount of total information recorded and history of nicotine dependence. RESULTS: A stable historical record of cigarette smoking in the region of 30-40% across the 3 years sampled was found, but the rate of formal diagnosis of nicotine dependence rose from 3.6% in 1996 to 26.3% in 1998. This rise was in the context of relative stability over this time period of: size of reports and relevant sections (alcohol and drug history, cigarette smoking history); three other key diagnoses, major depression, conduct disorder and alcohol dependence; and demographic data. The rise in rate of diagnosis proceeded specific discussion within the clinical team about nicotine dependence. CONCLUSIONS: Adolescent mental health settings are a key venue to address heavy and potentially chronic cigarette smoking, but nicotine dependence has been traditionally a neglected diagnosis in mental health patients. The rate of diagnosis is likely to rise when specific discussion is undertaken within clinical teams.
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