Cigarette Consumption and Related Factors in Schizophrenia, Schizoaffective Disorder and Delusional Disorder

Amaç: Bu çalışmada ayaktan tedavi gören şizofreni, şizoaffektif bozukluk ve sanrılı bozukluk hastalarında sigara kullanma sıklığını ve bununla ilişkili etmenleri belirlemek amaçlanmıştır. Yöntem: DSM-IV'e göre şizofreni, şizoaffektif bozukluk ve sanrılı bozukluk tanısı alan 541 hastanın dosyası geriye dönük olarak incelendi. Hastaların günlük sigara kullanma miktarı, nüfus özellikleri ve hastalıklarıyla ilişkili dosya verileri değerlendirildi. Sigara içimiyle ilişkili etmenleri belirlemek için lojistik regresyon, günlük sigara tüketimi miktarıyla ilişkili etmenleri araştırmak için korelasyon analizi kullanıldı.Bulgular: Çalışmaya dahil edilen 541 hastanın %44.7'sinin (n=242) düzenli olarak sigara kullandığı belirlendi. Erkeklerin sigara kullanma oranı kadınlarınkinden anlamlı derecede yüksekti. Şizofreni, şizoaffektif bozukluk ve sanrılı bozukluk hastalarında çalışmada ele alınan nüfus özellikleri ve hastalıklarıyla ilişkili değişkenler açısından farklılıklar olmasına rağmen, sigara içimi sıklığı bakımından fark saptanmadı. Lojistik regresyon analizi uygulandığında psikotik bozukluklarda sigara kullanımının, erkek cinsiyet ve hastalandıktan sonraki şiddet davranışı ile ilişkili olduğu saptandı. Günlük tüketilen ortalama sigara sayısının ise hastalık süresiyle orta derecede pozitif bağıntılı olduğu bulundu.Sonuç: Çalışmada psikotik bozukluklarda sigara kullanma oranları birbirine benzer bulunmuştur. Sigara kullanımı ile erkek cinsiyet ve hastalandıktan sonraki şiddet davranışı arasında kuvvetli bir ilişki olduğu görülmektedir. Şiddet davranışı ve sigara içimi arasındaki ilişki daha fazla incelenmeye değer yeni bir alan olarak belirmektedir

Şizofreni, şizoaffektif bozukluk ve sanrılı bozuklukta sigara tüketimi ve ilişkili etmenler

Objective: The present study is designed to assess the rate of smoking and related factors in outpatients with schizophrenia, schizoaffective disorder and delusional disorder. Methods: Medical records of 541 patients, diagnosed with schizophrenia, schizoaffective disorder and delusional disorder according to DSM-IV were examined retrospectively. Daily cigarette consumption, sociodemographic characteristics and medical data of the patients were evaluated. Logistic regression analysis was conducted to determine the factors associated with smoking. Correlation analysis was performed to assess factors related with daily cigarette consumption.Results: Of the 541 patients, 242 (44.7%) were current smokers. Smoking rate was significantly higher in males. Although there were differences in sociodemographic characteristics and disorder related variables, there was no difference in smoking rates of patients with schizophrenia, schizoaffective disorder, and delusional disorder. In logistic regression analysis it was shown that smoking was associated with male gender and violent behavior after illness onset in psychotic disorders. Correlation analysis showed that mean number of daily consumed cigarettes correlated moderately with the duration of the illness. Conclusions: In the study, similar smoking rates were found between psychotic disorders. Smoking is strongly related with male gender and violent behavior after onset of illness. The relation between smoking and violent behavior emerges as a new field deserving further investigation

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1. Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH. Smoking and mental illness: a population-based prevalence study. JAMA 2000; 284: 2606-2610. [CrossRef]
2. Kalman D, Smith SS. Does nicotine do what we think it does? Ameta-analytic review of the subjective effects of nicotine in nasal spray and intravenous studies with smokers and nonsmokers. Nicotine Tob Res 2005; 7:317-333. [CrossRef]
3. Ziedonis D, Williams JM, Smelson D. Serious mental illness and tobacco addiction: a model program to address this common but neglected issue. Am J Med Sci 2003; 326:223-230. [CrossRef]
4. Berlin I, Singleton EG, Pedarriosse AM, Lancrenon S, Rames A, Aubin HJ, Niaura R. The modified reasons for smoking scale: factorial structure, gender effects and relationship with nicotine dependence and smoking cessation in French smokers. Addiction 2003; 98:1575-1583. [CrossRef]
5. de Oliveira RM, Siqueira Júnior AC, Santos JL, Furegato AR. Nicotine dependence in the mental disorders, relationship with clinical indicators, and the meaning for the user. Rev Lat Am Enfermagem 2014; 22:685-692. [CrossRef]
6. Gurpegui M, Martinez-Ortega JM, Jurado D, Aguilar MC, Diaz FJ, de Leon J. Subjective effects and the main reason for smoking in outpatients with schizophrenia: a case-control study. Compr Psychiatry 2007; 48:186-191. [CrossRef]
7. Picciotto MR, Corrigall WA: Neuronal systems underlying behaviors related to nicotine addiction: neural circuits and molecular genetics. J Neurosci 2002; 22:3338-3341.
8. Sacco KA, Termine A, Seyal A, Dudas MM, Vessicchio JC, Krishnan-Sarin S, Jatlow PI, Wexler BE, George TP. Effects of cigarette smoking on spatial working memory and attentional deficits in schizophrenia. Arch GenPsychiatry 2005; 62:649-659. [CrossRef]
9. Barr RS, Culhane MA, Jubelt LE, Mufti RS, Dyer MA, Weiss AP, Deckersbach T, Kelly JF, Freudenreich O, Goff DC, Evins AE. The effects of transdermal nicotine on cognition in nonsmokers with schizophrenia and nonpsychiatric controls. Neuropsychopharmacology 2008; 33:480-490. [CrossRef]
10. Ahn Allen CG, Nestor PG, Shenton ME, McCarley RW, Niznikiewicz MA. Early nicotine withdrawal and transdermal nicotine effects on neurocognitive performance in schizophrenia. Schizophr Res 2008; 100:261-269. [CrossRef]
11. Hambsch B, Keyworth H, Lind J, Otte DM, Racz I, Kitchen I, Bailey A, Zimmer A. Chronic nicotine improves short-term memory selectively in a G72 mouse model of schizophrenia. Br J Pharmacol 2014; 171:1758-1771. [CrossRef]
12. AhnAllen CG, Bidwell LC, Tidey JW. Cognitive effects of very low nicotine content cigarettes, with and without nicotine replacement, in smokers with schizophrenia and controls. Nicotine Tob Res 2015; 17:510-514. [CrossRef]
13. George TP, Verrico CD, Xu L, Roth RH. Effects of repeated nicotine administration and footshock stress on rat mesoprefrontal dopamine systems: evidence for opioid mechanisms. Neuropsychopharmacology 2000; 23:79-88. [CrossRef]
14. Goff DC, Henderson DC, Amico E. Cigarette smoking in schizophrenia: relationship to psychopathology and medication side effects. Am J Psychiatry 1992; 149:1189-1194. [CrossRef]
15. Barnes M, Lawford BR, Burton SC, Heslop KR, Noble EP, Hausdorf K, Young RM. Smoking and schizophrenia: is symptom profile related to smoking and which antipsychotic medication is of benefit in reducing cigarette use? Aust N Z J Psychiatry 2006; 40:575-580. [CrossRef]
16. McEvoy JP, Freudenreich O, Wilson WH. Smoking and therapeutic response to clozapine in patients with schizophrenia. Biol Psychiatry 1999; 46:125-129. [CrossRef]
17. Turan T, Dolu N, Ozsoy S, Kılıç C, Beflirli A, Esel E. Effects of smoking on P50 wave form in schizophrenic patients. Bulletin of Clinical Psychopharmacology 2009; 19:227-235. [CrossRef]
18. Chen XS, Li CB, Smith RC, Xiao ZP, Wang JJ. Differential sensory gating functions between smokers and non-smokers among drug-naive first episode schizophrenic patients. Psychiatry Res 2011; 188:327-333. [CrossRef]
19. Olincy A, Freedman R. Nicotinic mechanisms in the treatment of psychotic disorders: a focus on the α7 nicotinic receptor. Handb Exp Pharmacol 2012; 213:211-232. [CrossRef]
20. Freedman R, Olincy A, Buchanan RW, Harris JG, Gold JM, Johnson L, Allensworth D, Guzman-Bonilla A, Clement B, Ball MP, Kutnick J, Pender V, Martin LF, Stevens KE, Wagner BD, Zerbe GO, Soti F, Kem WR.Initial phase 2 trial of a nicotinic agonist in schizophrenia. Am J Psychiatry 2008; 165:1040-1047.
21. Uzun O, Cansever A, Basoglu C, Ozsahin A. Smoking and substance abuse in outpatients with schizophrenia: a 2-year follow up study in Turkey. Drug Alcohol Depend 2003; 70:187- 192. [CrossRef]
22. Ekinci O, Ekinci A. Cigarette smoking in patients with schizophrenia in Turkey: relationships to psychopathology, socio-demographic and clinical characteristics. Dusunen Adam: The Journal of Psychiatry and Neurological Sciences 2012; 25:321-329. (Turkish)
23. Yildiz M, Yazici A, Boke O. Demographic and clinical characteristics in schizophrenia: a multi center cross-sectional case record study. Turk Psikiyatri Derg 2010; 21:213-224. (Turkish)
24. Ucok A, Polat A, Bozkurt O, Meteris H. Cigarette smoking among patients with schizophrenia and bipolar disorders. Psychiatry Clin Neurosci 2004; 58:434-437. [CrossRef]
25. Karsidag C, Alpay N, Kocabiyik A. Schizophrenia and cigarette dependence. Dusunen Adam: The Journal of Psychiatry and Neurological Sciences 2005; 18:13-20. (Turkish)
26. Tanriover O, Karamustafalioglu N, Tezvaran Z, Kaplan A, Tomruk N. Frequency of cigarette smoking among psychiatric inpatients evaluated by the Fagerström Test for Nicotine Dependence. Asian Pac J Cancer Prev 2013; 14:579-582. [CrossRef]
27. Yildiz M, Ozcan ME. The prevalence of nicotine dependence in psychiatric outpatients. Journal of Dependence 2000; 1:86-88. (Turkish)
28. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. (Turkish)
29. Giovino GA, Mirza SA, Samet JM, Gupta PC, Jarvis MJ, Bhala N, Peto R, Zatonski W, Hsia J, Morton J, Palipudi KM, Asma S; GATS Collaborative Group. Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys. Lancet 2012; 380:668-679. [CrossRef]
30. Herran A, de Santiago A, Sandoya M, Fernandez MJ, DiezManrique JF, Vazquez-Barquero JL. Determinants of smoking behaviour in outpatients with schizophrenia. Schizophr Res 2000; 41:373-381. [CrossRef]
31. Salokangas RK, Honkonen T, Stengard E, Koivisto AM, Hietala J. Cigarette smoking in long-term schizophrenia. Eur Psychiatry 2006; 21:219-223. [CrossRef]
32. Beratis S, Katrivanou A, Gourzis P. Factors affecting smoking in schizophrenia. Compr Psychiatry 2001; 42:393-402. [CrossRef]
33. Xu YM, Chen HH, Li F, Deng F, Liu XB, Yang HC, Qi LG, Guo JH, Liu TB. Prevalence and correlates of cigarette smoking among Chinese schizophrenia inpatients receiving antipsychotic monotherapy. PLoS ONE 2014; 9:e88478. [CrossRef]
34. Li Y, Hou CL, Ma XR, Zang Y, Jia FJ, Zhong BL, Lin YQ, Chiu HF, Ungvari GS, Himelhoch S, Cao XL, Cai MY, Lai KY, Xiang YT. Smoking and its associations with sociodemographic and clinical characteristics and quality of life in patients with schizophrenia treated in primary care in China. Gen Hosp Psychiatry 2016; 38:79-83. [CrossRef]
35. Morris CD, Giese AA, Turnbull JJ, Dickinson M, JohnsonNagel N. Predictors of tobacco use among persons with mental illnesses in a statewide population. Psychiatr Serv 2006; 57:1035- 1038. [CrossRef]
36. Chandra PS, Carey MP, Carey KB, Jairam KR, Girish NS, Rudresh HP. Prevalence and correlates of tobacco use and nicotine dependence among psychiatric patients in India. Addict Behav 2005; 30:1290-1299. [CrossRef]
37. Ratto LR, Menezes PR, Gulinelli A. Prevalence of tobacco use in individuals with severe mental illnesses, Sao Paulo, Brazil. Rev Saude Publica 2007; 41:510-516. [CrossRef]
38. Fallon JH, Keator DB, Mbogori J, Taylor D, Potkin SG. Gender: a major determinant of brain response to nicotine. Int J Neuropsychopharmacol 2005; 8:17-26. [CrossRef]
39. Wray JM, Gray KM, McClure EA, Carpenter MJ, Tiffany ST, Saladin ME. Gender differences in responses to cues presented in the natural environment of cigarette smokers. Nicotine Tob Res 2015; 17:438-442. [CrossRef]
40. Perkins KA, Karelitz JL. Sex differences in acute relief of abstinence-induced withdrawal and negative affect due to nicotine content in cigarettes. Nicotine Tob Res 2015; 17:443- 448. [CrossRef]
41. Brown AK, Mandelkern MA, Farahi J, Robertson C, Ghahremani DG, Sumerel B, Moallem N, London ED. Sex differences in striatal dopamine D2/D3 receptor availability in smokers and non-smokers. Int J Neuropsychopharmacol 2012; 15:989-994. [CrossRef]
42. Cosgrove KP, Esterlis I, McKee SA, Bois F, Seibyl JP, Mazure CM, Krishnan-Sarin S, Staley JK, Picciotto MR, O’Malley SS. Sex differences in availability of beta2*-nicotinic acetylcholine receptors in recently abstinent tobacco smokers. Arch Gen Psychiatry 2012; 69:418-427. [CrossRef]
43. Sofuoglu M, Mitchell E, Mooney M. Progesterone effects on subjective and physiological responses to intravenous nicotine in male and female smokers. Hum Psychopharmacol 2009; 24:559- 564. [CrossRef]
44. D’Souza DC, Esterlis I, Carbuto M, Krasenics M, Seibyl J, Bois F, Pittman B, Ranganathan M, Cosgrove K, Staley J. Lower ß2*-nicotinic acetylcholine receptor availability in smokers with schizophrenia. Am J Psychiatry 2012; 169:326-334. [CrossRef]
45. Brody AL, Mandelkern MA, London ED, Olmstead RE, Farahi J, Scheibal D, Jou J, Allen V, Tiongson E, Chefer SI, Koren AO, Mukhin AG. Cigarette smoking saturates brain alpha 4 beta 2 nicotinic acetylcholine receptors. Arch Gen Psychiatry 2006; 63:907-915. [CrossRef]
46. Aguocha CM, Aguocha JK, Igwe M, Uwakwe RU, Onyeama GM. Prevalence and correlates of cigarette smoking among patients with schizophrenia in southeast Nigeria. Acta Psychiatr Scand 2015; 131:206-212. [CrossRef]
47. Wijesundera H, Hanwella R, de Silva VA. Antipsychotic medication andtobacco use among outpatients with schizophrenia: a cross-sectional study. Ann Gen Psychiatry 2014; 13:7. [CrossRef]
48. Kotov R, Guey LT, Bromet EJ, Schwartz JE. Smoking in schizophrenia: diagnostic specificity, symptom correlates, and illness severity. Schizophr Bull 2010; 36:173-181. [CrossRef]
49. Diaz FJ, Velasquez DM, Susce MT, de Leon J. The association between schizophrenia and smoking: unexplained by either the illness or the prodromal period. Schizophr Res 2008; 104:214- 219. [CrossRef]
50. Martin LF, Leonard S, Hall MH, Tregellas JR, Freedman R, Olincy A. Sensory gating and alpha-7 nicotinic receptor gene allelic variants in schizoaffective disorder, ipolar type. Am J Med Genet B Neuropsychiatr Genet 2007; 144B:611-614. [CrossRef]
51. Delfino RJ, Jamner LD, Whalen CK. Temporal analysis of the relationship of smoking behavior and urges to mood states in men versus women. Nicotine Tob Res 2001; 3:235-248. [CrossRef]
52. Allen MH, Debanne M, Lazignac C, Adam E, Dickinson LM, Damsa C. Effect of nicotine replacement therapy on agitation in smokers with schizophrenia: a double-blind, randomized, placebo-controlled study. Am J Psychiatry 2011; 168:395-399. [CrossRef]
53. Picciotto MR, Lewis AS, van Schalkwyk GI, Mineur YS. Mood and anxiety regulation by nicotinic acetylcholine receptors: Apotential pathway to modulate aggression and related behavioral states. Neuropharmacology 2015; 96:235-243. [CrossRef]