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Lok YL, Tan GPP, Subramaniam M, van der Eijk Y. "Everybody's problem but nobody's problem": Qualitative study on integrating smoking cessation and mental health services in Singapore. PLoS One 2025; 20:e0322786. [PMID: 40333884 PMCID: PMC12057880 DOI: 10.1371/journal.pone.0322786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Accepted: 03/26/2025] [Indexed: 05/09/2025] Open
Abstract
BACKGROUND Although quitting smoking benefits mental health, people with mental health conditions tend to have higher smoking rates and more severe tobacco use disorders. Integration of smoking cessation into mental healthcare, or vice versa, could help to meet the needs of this population. While Singapore offers specialist smoking cessation and mental health services, it is unclear how these services address the needs of people with comorbid tobacco use and mental health issues. This study aimed to explore the integration of smoking cessation and mental health services in Singapore from the perspective of healthcare professionals. METHODS We conducted one-on-one semi-structured interviews with 21 Singaporean health professionals with expertise in mental health (n = 5), smoking cessation (n = 5), primary healthcare (n = 3), specialist respiratory or emergency care (n = 3) or health systems and policy (n = 5). We recruited participants from the authors' professional networks and subsequently via snowballing. We used inductive coding methods to identify themes that emerged from the data. RESULTS Health professionals were divided on whether smoking and mental health are sufficiently interconnected to justify more integrated or tailored services. Smoking cessation and mental health were generally approached in a siloed manner, reflecting systemic barriers to integration as well as ranging levels of awareness among health professionals on the association between smoking and mental health. While some participants welcomed the integration of smoking cessation and mental health services as a more convenient, effective and equitable way to address the needs of this population, others deemed it unnecessary and viewed smoking as a lifestyle habit, distinct from other mental health issues. IMPLICATIONS There is a need to educate health professionals on smoking as a mental health issue and to consider more tailored programmes designed to address smoking cessation and mental health needs simultaneously.
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Affiliation(s)
- Yee Ling Lok
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Grace Ping Ping Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Mythily Subramaniam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Institute of Mental Health, Singapore, Singapore
| | - Yvette van der Eijk
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Pourebrahim S, Ahmad T, Rottmann E, Schulze J, Scheller B. Does Cannabis Use Contribute to Schizophrenia? A Causation Analysis Based on Epidemiological Evidence. Biomolecules 2025; 15:368. [PMID: 40149904 PMCID: PMC11940535 DOI: 10.3390/biom15030368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2024] [Revised: 01/29/2025] [Accepted: 02/24/2025] [Indexed: 03/29/2025] Open
Abstract
Cannabis abuse has been linked to acute psychotic symptoms as well as to the development of schizophrenia. Although the association has been well described, causation has not yet been investigated. Therefore, we investigated whether cannabis or cannabinoid use is causal for the development of schizophrenia, conducting a systematic literature review according to the PRISM guidelines. Epidemiological studies and randomized clinical trials investigating the links between cannabis and psychosis-like events (PLE) and schizophrenia were identified (according to PRISM guidelines), and relevant studies were included in a Forest plot analysis. Confounder analysis was performed using a funnel plot, and the Hill causality criteria were used to estimate causation. A total of 18 studies fulfilled the search criteria; 10 studies were included in a forest plot. All studies reported an increased risk for PLE or schizophrenia, and nine of the ten studies, a significant increase; the overall OR was calculated to be 2.88 (CI 2.24 to 3.70), with a twofold-higher risk calculated for cannabis use during adolescence. Confounder effects were indicated by a funnel plot. The Hill criteria indicated a high likelihood for the contribution of cannabis to schizophrenia development. Cannabinoids likely contribute to chronic psychotic events and schizophrenia, especially if taken during adolescence. This effect likely increases with a high cannabis THC concentration and increased frequency of cannabis use, and is stronger in males than in females. This points to the possibility of a selective cannabis toxicity on synaptic plasticity in adolescence, as compared to adult cannabis use. Cannabis use should be regulated and discouraged, and prevention efforts should be strengthened, especially with reference to adolescence.
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Affiliation(s)
- Sepehr Pourebrahim
- Clinic of Anesthesiology, Surgical Intensive Care, Emergency Medicine and Pain Medicine, Main-Kinzig-Kliniken, Herzbachweg 14, D-63571 Gelnhausen, Germany (E.R.)
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, D-60590 Frankfurt/Main, Germany;
| | - Tooba Ahmad
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, D-60590 Frankfurt/Main, Germany;
- Paediatric Department, Epsom General Hospital, Epsom and St Helier University Hospitals NHS Trust, Dorking Road, Epsom KT18 7EG, Surrey, UK
| | - Elisabeth Rottmann
- Clinic of Anesthesiology, Surgical Intensive Care, Emergency Medicine and Pain Medicine, Main-Kinzig-Kliniken, Herzbachweg 14, D-63571 Gelnhausen, Germany (E.R.)
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, D-60590 Frankfurt/Main, Germany;
| | - Johannes Schulze
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, D-60590 Frankfurt/Main, Germany;
| | - Bertram Scheller
- Anesthesiological Clinic, St. Josef-Hospital Wiesbaden, Beethovenstraße 20, D-65189 Wiesbaden, Germany;
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Li W, Yue L, Xiao S. Demographic, biochemical, clinical, and cognitive symptom differences between smokers and non-smokers in Chinese older male patients with chronic schizophrenia. Eur Arch Psychiatry Clin Neurosci 2025; 275:193-199. [PMID: 38462585 PMCID: PMC11799016 DOI: 10.1007/s00406-024-01762-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 01/13/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Several studies have suggested that smoking may impair cognitive function and worsen psychiatric symptoms in people with schizophrenia, but the results have not been consistent. There have been few studies to date that have examined the effects of smoking in older men with chronic schizophrenia. METHODS The participants in our study consisted of 167 order Chinese males with chronic schizophrenia and 359 normal control subjects. We split them into smoking and non-smoking groups based on whether or not they smoked. Second, we compared their differences in terms of general demographic characteristics (such as age, education, body mass index, age of illness onset, and course of disease), disease information (such as hypertension, diabetes, and hyperlipidemia), lifestyle factors (such as physical exercise and lunch break), blood biochemical indicators (such as albumin, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein and fasting blood glucose), and medication usage (such as clozapine, olanzapine, risperidone, and chlorpromazine). Lastly, a neuropsychological test battery was used to assess their psychiatric and cognitive symptoms, for example, the Montreal Cognitive Assessment (MoCA) was used to assess their overall cognitive functioning. Their depressive symptoms were assessed by the geriatric depression scale (GDS). Activities of daily living (ADL) were used to assess their ability to lead a daily life, while the positive and negative syndrome scales (PANSS) were used to assess their psychiatric symptoms. RESULTS Smokers who develop schizophrenia at older ages had a higher body mass index than non-smokers. We also found that plasma albumin, triglycerides, low-density lipoprotein, and fasting blood glucose concentrations were significantly higher in smokers. In contrast, smokers with schizophrenia also had lower PANSS total scores, negative symptom scores, and general psychopathology scores. A forward stepwise binary logistics regression analysis demonstrated a significant association between negative symptom scores and smoking status (B = 0.112, p < 0.001, OR = 1.119, 95% confidence interval: 1.059-1.181). Correlation analysis was carried out and it was found that the amount of cigarette consumption per day had a negative correlation with plasma albumin level(r = - 0.290, p = 0.004). However, no such association was found in normal controls. CONCLUSIONS Elderly Chinese men with schizophrenia have a higher percentage of smokers, and although smoking can reduce their plasma albumin levels, it does contribute to the prevention of negative symptoms.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
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Caspi A, Shireby G, Mill J, Moffitt TE, Sugden K, Hannon E. Accelerated Pace of Aging in Schizophrenia: Five Case-Control Studies. Biol Psychiatry 2024; 95:1038-1047. [PMID: 37924924 PMCID: PMC11063120 DOI: 10.1016/j.biopsych.2023.10.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/29/2023] [Accepted: 10/21/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Schizophrenia is associated with increased risk of developing multiple aging-related diseases, including metabolic, respiratory, and cardiovascular diseases, and Alzheimer's and related dementias, leading to the hypothesis that schizophrenia is accompanied by accelerated biological aging. This has been difficult to test because there is no widely accepted measure of biological aging. Epigenetic clocks are promising algorithms that are used to calculate biological age on the basis of information from combined cytosine-phosphate-guanine sites (CpGs) across the genome, but they have yielded inconsistent and often negative results about the association between schizophrenia and accelerated aging. Here, we tested the schizophrenia-aging hypothesis using a DNA methylation measure that is uniquely designed to predict an individual's rate of aging. METHODS We brought together 5 case-control datasets to calculate DunedinPACE (Pace of Aging Calculated from the Epigenome), a new measure trained on longitudinal data to detect differences between people in their pace of aging over time. Data were available from 1812 psychosis cases (schizophrenia or first-episode psychosis) and 1753 controls. Mean chronological age was 38.9 (SD = 13.6) years. RESULTS We observed consistent associations across datasets between schizophrenia and accelerated aging as measured by DunedinPACE. These associations were not attributable to tobacco smoking or clozapine medication. CONCLUSIONS Schizophrenia is accompanied by accelerated biological aging by midlife. This may explain the wide-ranging risk among people with schizophrenia for developing multiple different age-related physical diseases, including metabolic, respiratory, and cardiovascular diseases, and dementia. Measures of biological aging could prove valuable for assessing patients' risk for physical and cognitive decline and for evaluating intervention effectiveness.
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Affiliation(s)
- Avshalom Caspi
- Department of Psychology & Neuroscience, Duke University, Durham, North Carolina; Social, Genetic and Developmental Psychiatry, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, United Kingdom; PROMENTA, Department of Psychology, University of Oslo, Oslo, Norway.
| | - Gemma Shireby
- Centre of Longitudinal Studies, University College London, Exeter, United Kingdom
| | - Jonathan Mill
- University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Terrie E Moffitt
- Department of Psychology & Neuroscience, Duke University, Durham, North Carolina; Social, Genetic and Developmental Psychiatry, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, United Kingdom; PROMENTA, Department of Psychology, University of Oslo, Oslo, Norway
| | - Karen Sugden
- Department of Psychology & Neuroscience, Duke University, Durham, North Carolina
| | - Eilis Hannon
- University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
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Li YT, Zhang C, Han JC, Shang YX, Chen ZH, Cui GB, Wang W. Neuroimaging features of cognitive impairments in schizophrenia and major depressive disorder. Ther Adv Psychopharmacol 2024; 14:20451253241243290. [PMID: 38708374 PMCID: PMC11070126 DOI: 10.1177/20451253241243290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 03/14/2024] [Indexed: 05/07/2024] Open
Abstract
Cognitive dysfunctions are one of the key symptoms of schizophrenia (SZ) and major depressive disorder (MDD), which exist not only during the onset of diseases but also before the onset, even after the remission of psychiatric symptoms. With the development of neuroimaging techniques, these non-invasive approaches provide valuable insights into the underlying pathogenesis of psychiatric disorders and information of cognitive remediation interventions. This review synthesizes existing neuroimaging studies to examine domains of cognitive impairment, particularly processing speed, memory, attention, and executive function in SZ and MDD patients. First, white matter (WM) abnormalities are observed in processing speed deficits in both SZ and MDD, with distinct neuroimaging findings highlighting WM connectivity abnormalities in SZ and WM hyperintensity caused by small vessel disease in MDD. Additionally, the abnormal functions of prefrontal cortex and medial temporal lobe are found in both SZ and MDD patients during various memory tasks, while aberrant amygdala activity potentially contributes to a preference to negative memories in MDD. Furthermore, impaired large-scale networks including frontoparietal network, dorsal attention network, and ventral attention network are related to attention deficits, both in SZ and MDD patients. Finally, abnormal activity and volume of the dorsolateral prefrontal cortex (DLPFC) and abnormal functional connections between the DLPFC and the cerebellum are associated with executive dysfunction in both SZ and MDD. Despite these insights, longitudinal neuroimaging studies are lacking, impeding a comprehensive understanding of cognitive changes and the development of early intervention strategies for SZ and MDD. Addressing this gap is critical for advancing our knowledge and improving patient prognosis.
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Affiliation(s)
- Yu-Ting Li
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Chi Zhang
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
- Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Jia-Cheng Han
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Yu-Xuan Shang
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Zhu-Hong Chen
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Guang-Bin Cui
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi’an 710038, Shaanxi, China
| | - Wen Wang
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi’an 710038, Shaanxi, China
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Mu X, Wu W, Wang S, Su X, Guan H, Guan X, Lu X, Li Z. Smoking affects symptom improvement in schizophrenia: a prospective longitudinal study of male patients with first-episode schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2024; 10:34. [PMID: 38491003 PMCID: PMC10943037 DOI: 10.1038/s41537-024-00449-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/12/2024] [Indexed: 03/18/2024]
Abstract
Patients with schizophrenia (SCZ) smoke up to three times more than general people. However, there are conflicting results regarding the relationship between tobacco smoke and clinical symptom severity in SCZ. The aim of this study was to assess the impact of smoking on clinical symptoms after antipsychotic treatment in a 12-week cohort study after controlling for confounding factors. One hundred and forty-five male patients with drug-naïve first-episode (DNFE) SCZ received antipsychotic monotherapy for 12 weeks. Symptom severity was assessed at baseline and at week 12 by the Positive and Negative Syndrome Scale (PANSS). We found no differences in clinical symptoms among male smokers with SCZ compared with male nonsmokers. However, male smokers showed greater improvement in negative symptoms after 12 weeks of treatment, controlling for age, years of education, onset age, and baseline body mass index (BMI). Our study showed that after 12 weeks of treatment with antipsychotics, male smokers showed greater improvement in negative symptoms than male nonsmokers.
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Affiliation(s)
- Xishu Mu
- Hebei Province Veterans Hospital, Baoding, China
| | - Wenjing Wu
- Qingdao Mental Health Center, Qingdao, China
| | - Sisi Wang
- Qingdao Mental Health Center, Qingdao, China
| | - Xiuru Su
- Hebei Province Veterans Hospital, Baoding, China
| | | | - Xiaoni Guan
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | - Xiaobing Lu
- Department of Nutritional and Metabolic Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
| | - Zezhi Li
- Department of Nutritional and Metabolic Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
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Yeh LL, Lee WC, Kuo KH, Pan YJ. Antipsychotics and Mortality in Adult and Geriatric Patients with Schizophrenia. Pharmaceuticals (Basel) 2023; 17:61. [PMID: 38256894 PMCID: PMC10819180 DOI: 10.3390/ph17010061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/20/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024] Open
Abstract
Patients with schizophrenia have a high mortality risk, and the role of antipsychotic medications remains inconclusive. In an aging society, older patients with schizophrenia warrant increased attention. This study investigated the association of antipsychotic medication dosages with mortality in patients with schizophrenia by using data from Taiwan's National Health Insurance Research Database from 2010 to 2014. This study included 102,964 patients with schizophrenia and a subgroup of 6433 older patients in addition to an age- and sex-matched control group. The findings revealed that among patients with schizophrenia, the no antipsychotic exposure group had the highest mortality risk (3.61- and 3.37-fold higher risk for overall and cardiovascular mortality, respectively) in the age- and sex-adjusted model, followed by the high, low, and moderate exposure groups. A similar pattern was observed in the older patients with schizophrenia. High exposure to antipsychotics was associated with the highest risks of overall and cardiovascular mortality (3.01- and 2.95-fold higher risk, respectively). In conclusion, the use of antipsychotics can be beneficial for patients with schizophrenia with recommended exposure levels being low to moderate. In older patients, high antipsychotic exposure was associated with the highest mortality risk, indicating that clinicians should be cautious when administering antipsychotic medications to such patients.
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Affiliation(s)
- Ling-Ling Yeh
- Graduate School of Humanities and Social Sciences, Dharma Drum Institute of Liberal Arts, New Taipei City 208, Taiwan;
| | - Wei-Chen Lee
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan;
| | - Kuei-Hong Kuo
- Division of Medical Imaging, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Yi-Ju Pan
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan;
- Department of Chemical Engineering and Materials Science, Yuan Ze University, Taoyuan City 320, Taiwan
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Santhosh Kumar S, Cantillo R, Ye D. The Relationship between Oral Health and Schizophrenia in Advanced Age-A Narrative Review in the Context of the Current Literature. J Clin Med 2023; 12:6496. [PMID: 37892634 PMCID: PMC10607055 DOI: 10.3390/jcm12206496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/13/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Schizophrenia is a psychiatric disorder that makes patients incompetent to perform day-to-day activities due to their progressing mental illness. In addition to disturbances with thoughts, behavioral changes, and impaired cognitive functions, oro-systemic health also becomes compromised. Even though the population with schizophrenia is primarily made up of older people, little is known about this group's oral health treatment. The present review explores the relationship between oral healthcare and elderly patients with schizophrenia. Our literature search included databases, like PubMed, Embase, and Google Scholar, for appropriate and evidence-based information. Preventive and management strategies outlined in the included articles and future research perspectives in this field are discussed. To the best of our knowledge, this is the first review that looked at dental care and related characteristics in older schizophrenia patients. The findings highlight the necessity for targeted dental interventions to address the dental health challenges faced by this vulnerable population. Integrating dental health into the overall medical management of elderly individuals with schizophrenia is crucial. Although specific therapies remain limited, the emphasis is on preventive dentistry to reduce the occurrence and progression of oral diseases in this group.
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Affiliation(s)
| | | | - Dongxia Ye
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY 14620, USA or (S.S.K.); or (R.C.)
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Wells AC, Lotfipour S. Prenatal nicotine exposure during pregnancy results in adverse neurodevelopmental alterations and neurobehavioral deficits. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11628. [PMID: 38389806 PMCID: PMC10880762 DOI: 10.3389/adar.2023.11628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/28/2023] [Indexed: 02/24/2024]
Abstract
Maternal tobacco use and nicotine exposure during pregnancy have been associated with adverse birth outcomes in infants and can lead to preventable pregnancy complications. Exposure to nicotine and other compounds in tobacco and electronic cigarettes (e-cigarettes) has been shown to increases the risk of miscarriage, prematurity, stillbirth, low birth weight, perinatal morbidity, and sudden infant death syndrome (SIDS). Additionally, recent data provided by clinical and pre-clinical research demonstrates that nicotine exposure during pregnancy may heighten the risk for adverse neurodevelopmental disorders such as Attention-Deficit Hyperactivity (ADHD), anxiety, and depression along with altering the infants underlying brain circuitry, response to neurotransmitters, and brain volume. In the United States, one in 14 women (7.2%) reported to have smoked cigarettes during their pregnancy with the global prevalence of smoking during pregnancy estimated to be 1.7%. Approximately 1.1% of women in the United States also reported to have used e-cigarettes during the last 3 months of pregnancy. Due to the large percentage of women utilizing nicotine products during pregnancy in the United States and globally, this review seeks to centralize pre-clinical and clinical studies focused on the neurobehavioral and neurodevelopmental complications associated with prenatal nicotine exposure (PNE) such as alterations to the hypothalamic-pituitary-adrenal (HPA) axis and brain regions such as the prefrontal cortex (PFC), ventral tegmental area (VTA), nucleus accumbens (NA), hippocampus, and caudate as well as changes to nAChR and cholinergic receptor signaling, long-term drug seeking behavior following PNE, and other related developmental disorders. Current literature analyzing the association between PNE and the risk for offspring developing schizophrenia, attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), anxiety, and obesity will also be discussed.
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Affiliation(s)
- Alicia C Wells
- School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Shahrdad Lotfipour
- School of Medicine, University of California, Irvine, Irvine, CA, United States
- Department of Emergency Medicine, Pharmaceutical Sciences, Pathology and Laboratory Medicine, University of California, Irvine, Irvine, CA, United States
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10
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Mouro Ferraz Lima T, Castaldelli-Maia JM, Apter G, Leopoldo K. Neurobiological associations between smoking and internalizing disorders. Int Rev Psychiatry 2023; 35:486-495. [PMID: 38299645 DOI: 10.1080/09540261.2023.2252907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/24/2023] [Indexed: 02/02/2024]
Abstract
People with severe mental disorders have a higher mortality rate due to preventable conditions like cardiovascular diseases and respiratory diseases. Nicotine addiction is a preventable risk factor, with tobacco use being twice as high in people with mental disorders. An integrative model that divides mental disorders into externalising, internalising, and thought disorders could be useful for identifying common causalities and risk factors. This review aims to examine the interface between smoking and internalising disorders, specifically schizophrenia, depressive disorders, and anxiety disorders. The review finds that there is a clear association between smoking behaviour and these disorders. Schizophrenia is associated with polymorphisms that result in an imbalance between glutamate and GABA release and abnormalities of dopaminergic pathways. Nicotine improves dopaminergic signalling and balances glutamatergic and GABAergic pathways, improving symptoms and increasing the risk of nicotine dependence. In depressive disorders, smoking is associated with functional changes in brain regions affected by smoking and self-medication. In anxiety disorders, there is a bidirectional relationship with smoking, involving the amygdala and changes in dopaminergic pathways and cortisol production. Smoking poses a threat to people living with psychiatric disorders and calls for further research to assess the interactions between nicotine dependence and internalising and thought disorders.
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Affiliation(s)
| | - João Mauricio Castaldelli-Maia
- Department of Neuroscience, Medical School, FMABC University Center
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
- Department of Psychiatry, Medical School, University of São Paulo, Brazil
| | - Gisèle Apter
- Societé de l'Information Psychiatrique, France
- University of Rouen Normandy, France
| | - Kae Leopoldo
- Department of Psychiatry, Medical School, University of São Paulo, Brazil
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Leonardsen EH, Vidal-Piñeiro D, Roe JM, Frei O, Shadrin AA, Iakunchykova O, de Lange AMG, Kaufmann T, Taschler B, Smith SM, Andreassen OA, Wolfers T, Westlye LT, Wang Y. Genetic architecture of brain age and its causal relations with brain and mental disorders. Mol Psychiatry 2023; 28:3111-3120. [PMID: 37165155 PMCID: PMC10615751 DOI: 10.1038/s41380-023-02087-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 05/12/2023]
Abstract
The difference between chronological age and the apparent age of the brain estimated from brain imaging data-the brain age gap (BAG)-is widely considered a general indicator of brain health. Converging evidence supports that BAG is sensitive to an array of genetic and nongenetic traits and diseases, yet few studies have examined the genetic architecture and its corresponding causal relationships with common brain disorders. Here, we estimate BAG using state-of-the-art neural networks trained on brain scans from 53,542 individuals (age range 3-95 years). A genome-wide association analysis across 28,104 individuals (40-84 years) from the UK Biobank revealed eight independent genomic regions significantly associated with BAG (p < 5 × 10-8) implicating neurological, metabolic, and immunological pathways - among which seven are novel. No significant genetic correlations or causal relationships with BAG were found for Parkinson's disease, major depressive disorder, or schizophrenia, but two-sample Mendelian randomization indicated a causal influence of AD (p = 7.9 × 10-4) and bipolar disorder (p = 1.35 × 10-2) on BAG. These results emphasize the polygenic architecture of brain age and provide insights into the causal relationship between selected neurological and neuropsychiatric disorders and BAG.
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Affiliation(s)
- Esten H Leonardsen
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, 0317, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, 0317, Oslo, Norway
| | - Didac Vidal-Piñeiro
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, 0317, Oslo, Norway
| | - James M Roe
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, 0317, Oslo, Norway
| | - Oleksandr Frei
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, 0317, Oslo, Norway
| | - Alexey A Shadrin
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, 0317, Oslo, Norway
- K.G. Jebsen Centre for Neurodevelopmental disorders, University of Oslo, Oslo, Norway
| | - Olena Iakunchykova
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, 0317, Oslo, Norway
| | - Ann-Marie G de Lange
- Department of Psychology, University of Oslo, 0317, Oslo, Norway
- LREN, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, 1015, Lausanne, Switzerland
- Department of Psychiatry, University of Oxford, OX1 2JD, Oxford, UK
| | - Tobias Kaufmann
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, 0317, Oslo, Norway
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, 72074, Tübingen, Germany
| | - Bernd Taschler
- Wellcome Centre for Integrative Neuroimaging (WIN FMRIB), University of Oxford, OX3 9DU, Oxford, United Kingdom
| | - Stephen M Smith
- Wellcome Centre for Integrative Neuroimaging (WIN FMRIB), University of Oxford, OX3 9DU, Oxford, United Kingdom
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, 0317, Oslo, Norway
- K.G. Jebsen Centre for Neurodevelopmental disorders, University of Oslo, Oslo, Norway
| | - Thomas Wolfers
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, 0317, Oslo, Norway
- Department of Psychology, University of Oslo, 0317, Oslo, Norway
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, 72074, Tübingen, Germany
| | - Lars T Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, 0317, Oslo, Norway
- K.G. Jebsen Centre for Neurodevelopmental disorders, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, 0317, Oslo, Norway
| | - Yunpeng Wang
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, 0317, Oslo, Norway.
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Pross B, Münz S, Nitsche MA, Padberg F, Strube W, Papazova I, Falkai P, Hasan A. Smoking status ameliorates cholinergic impairments in cortical inhibition in patients with schizophrenia. Brain Res 2023; 1812:148380. [PMID: 37121425 DOI: 10.1016/j.brainres.2023.148380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/20/2023] [Accepted: 04/26/2023] [Indexed: 05/02/2023]
Abstract
Rationale Modulation of cortical excitability, in particular inhibition, is impaired in patients with schizophrenia. Chronic nicotine consumption, which is prevalent in this group, has been shown to alter cortical excitability in healthy individuals and to increase inhibitory activity. Thus, beneficial effects of smoking on impaired cortical excitability in patients with schizophrenia have been proposed, though direct experimental evidence is still lacking. OBJECTIVES We aimed to explore the effect of chronic smoking on cortical excitability by comparing smoking and non-smoking patients with schizophrenia. METHOD Twenty-six smoking and 19 non-smoking patients diagnosed with schizophrenia were included. Transcranial magnetic stimulation (TMS) applied to the primary motor cortex served as experimental paradigm for measuring corticospinal and intracortical excitability as follows: Resting motor threshold (RMT) and the input/output curve (I/O curve) were obtained to assess corticospinal excitability. Intracortical excitability was explored using paired-pulse TMS techniques (intracortical facilitation (ICF), short-latency intracortical inhibition (SICI) and short-latency afferent inhibition (SAI)). RESULTS A significantly stronger inhibition in the cholinergically driven SAI protocol was observed in smokers compared to non-smokers. All other measures did not show significant differences between groups. CONCLUSION Our results suggest an increased inhibition within cholinergic circuits due to chronic nicotine consumption in schizophrenia. This increase may compensate impaired cholinergic neurotransmission and could explain the high rate of smokers in schizophrenia.
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Affiliation(s)
- Benjamin Pross
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Geschwister-Schönert-Str. 1, 86156 Augsburg, Germany.
| | - Susanne Münz
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Michael A Nitsche
- Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund, Dept. Psychology and Neurosciences, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Wolfgang Strube
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Geschwister-Schönert-Str. 1, 86156 Augsburg, Germany
| | - Irina Papazova
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Geschwister-Schönert-Str. 1, 86156 Augsburg, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Geschwister-Schönert-Str. 1, 86156 Augsburg, Germany
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13
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Keřková B, Knížková K, Siroňová A, Hrubý A, Večeřová M, Šustová P, Jonáš J, Rodriguez M. Smoking and attention in schizophrenia spectrum disorders: What are we neglecting? Front Psychol 2023; 14:1114473. [PMID: 37063581 PMCID: PMC10098154 DOI: 10.3389/fpsyg.2023.1114473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/07/2023] [Indexed: 04/18/2023] Open
Abstract
Introduction Individuals with schizophrenia spectrum disorders (SSDs) record elevated rates of smoking, which is often attributed to their effort to self-medicate cognitive and attentional symptoms of their illness. Empirical evidence for this hypothesis is conflicting, however. In this study, we aimed to test predictions derived from the cognitive self-medication hypothesis. We predicted that cigarette smoking status and extent would predict the attentional performance of participants with SSDs. Simultaneously, we wished to address methodological gaps in previous research. We measured distinct attentional components and made adjustments for the effects of other, attention-modulation variables. Methods Sixty-one smokers (82.0% males, 26.73 ± 6.05 years) and 61 non-smokers (50.8% males, 27.10 ± 7.90 years) with recent-onset SSDs completed an X-type Continuous Performance Test, which was used to derive impulsivity and inattention component scores. Relationships between the two component scores and cigarette smoking status and extent were assessed using hierarchical regression. Effects of estimated premorbid intellectual functioning and antipsychotic medication dosage were held constant. Results Smokers had significantly higher inattention component scores than non-smokers when covariates were controlled (p = 0.026). Impulsivity remained unaffected by smoking status (p = 0.971). Cigarette smoking extent, i.e., the number of cigarettes smoked per day, was not associated with either inattention (p = 0.414) or impulsivity (p = 0.079). Conclusion Models of smoking-related attentional changes can benefit from the inclusion of sample-specific component scores and attention-modulating covariates. Under these conditions, smokers with SSDs can show a partial attentional benefit. However, the limited scope of this benefit suggests that the cognitive self-medication hypothesis requires further testing or reconsidering.
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Affiliation(s)
- Barbora Keřková
- National Institute of Mental Health, Klecany, Czechia
- *Correspondence: Barbora Keřková,
| | - Karolína Knížková
- National Institute of Mental Health, Klecany, Czechia
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
| | - Aneta Siroňová
- National Institute of Mental Health, Klecany, Czechia
- Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czechia
| | - Aleš Hrubý
- National Institute of Mental Health, Klecany, Czechia
| | | | - Petra Šustová
- National Institute of Mental Health, Klecany, Czechia
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czechia
| | - Juraj Jonáš
- National Institute of Mental Health, Klecany, Czechia
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czechia
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14
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Xiu M, Song X, Yang H, Huang X, Wu F, Zhang X. Smoking Affects the Predictive Roles of Antioxidant Enzymes in the Clinical Response to Risperidone in Schizophrenia: A Large-scale Cohort Study. Curr Neuropharmacol 2023; 21:2151-2158. [PMID: 37132112 PMCID: PMC10556368 DOI: 10.2174/1570159x21666230502125800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/26/2022] [Accepted: 10/29/2022] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVES There is overwhelming evidence of the relationship between smoking and schizophrenia (SZ). Tobacco smoke is considered to ameliorate the symptoms and reduce the side effects of antipsychotics in SZ patients. However, the underlying biological mechanism by which tobacco smoke improves symptoms in SZ remains unclear. This study was designed to examine the effects of tobacco smoke on antioxidant enzyme activities and psychiatric symptoms after receiving 12-week risperidone monotherapy. METHODS Two hundred and fifteen antipsychotic-naïve first-episode (ANFE) patients were recruited and treated with risperidone for 3 months. The severity of the patient's symptoms was assessed by the Positive and Negative Syndrome Scale (PANSS) at baseline and at post-treatment. Plasma SOD, GSH-Px, and CAT activities were determined at baseline and follow-up. RESULTS Relative to nonsmoking patients with ANFE SZ, patients who smoked had higher baseline CAT activity. In addition, among non-smokers with SZ, baseline GSH-Px was associated with clinical symptom improvement, while baseline CAT was associated with positive symptom improvement in smokers with SZ. CONCLUSION Our findings demonstrate that smoking affects the predictive role of baseline SOD, GSHPx, and CAT activities on clinical symptom improvement in patients with SZ.
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Affiliation(s)
- Meihong Xiu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | - Xiuli Song
- Clinical Psychology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
| | - Hanlun Yang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Biomedical Engineering, Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Xingjuan Huang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Biomedical Engineering, Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Fengchun Wu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Biomedical Engineering, Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Xiangyang Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
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15
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Black Pepper (Piper nigrum) for Tobacco Withdrawal: A Case Report. Case Rep Psychiatry 2022; 2022:5908769. [DOI: 10.1155/2022/5908769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022] Open
Abstract
Tobacco use continues to be one of humanity’s most significant public health concerns, causing more than 8-million deaths annually. Existing treatments for tobacco use disorder are limited in efficacy and there is a strong need for identifying effective novel treatments. Small clinical trials indicate that black pepper (Piper nigrum) essential oil may be helpful for treating nicotine withdrawal and craving. However, we are unaware of any cases reporting the use of black pepper for these purposes in nonresearch settings. Here we present the case of a patient who inhaled combusted black pepper to self-medicate nicotine withdrawal when lacking access to tobacco cigarettes while incarcerated. Based on our patient’s report, inhalation of combusted black pepper may have alleviated his tobacco withdrawal and cravings by reducing his automatic motor urge to smoke, quelling withdrawal-associated anxiety, and mimicking the sensorimotor experience of smoking tobacco cigarettes. Notably, our patient reported that inhalation of combusted black pepper for treatment of nicotine craving and withdrawal was common in his correctional facility. Though combusted black pepper is highly unlikely to be an appealing treatment outside of a correctional setting, this case suggests that further investigation of vaporized black pepper essential oil for tobacco cessation may be warranted.
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Su MH, Lai RY, Lin YF, Chen CY, Feng YCA, Hsiao PC, Wang SH. Evaluation of the causal relationship between smoking and schizophrenia in East Asia. SCHIZOPHRENIA 2022; 8:72. [PMID: 36085329 PMCID: PMC9463183 DOI: 10.1038/s41537-022-00281-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 08/29/2022] [Indexed: 11/21/2022]
Abstract
Cigarette smoking has been suggested to be associated with the risk of schizophrenia in observational studies. A significant causal effect of smoking on schizophrenia has been reported in European populations using the Mendelian randomization approach; however, no evidence of causality was found in participants from East Asia. Using Taiwan Biobank (TWBB), we conducted genome-wide association studies (GWAS) to identify susceptibility loci for smoking behaviors, including smoking initiation (N = 79,989) and the onset age (N = 15,582). We then meta-analyzed GWAS from TWBB and Biobank Japan (BBJ) with the total sample size of 245,425 for smoking initiation and 46,000 for onset age of smoking. The GWAS for schizophrenia was taken from the East Asia Psychiatric Genomics Consortium, which included 22,778 cases and 35,362 controls. We performed a two-sample Mendelian randomization to estimate the causality of smoking behaviors on schizophrenia in East Asia. In TWBB, we identified one locus that met genome-wide significance for onset age. In a meta-analysis of TWBB and BBJ, we identified two loci for smoking initiation. In Mendelian randomization, genetically predicted smoking initiation (odds ratio (OR) = 4.00, 95% confidence interval (CI) = 0.89–18.01, P = 0.071) and onset age (OR for a per-year increase = 0.96, 95% CI = 0.91–1.01, P = 0.098) were not significantly associated with schizophrenia; the direction of effect was consistent with European Ancestry samples, which had higher statistical power. These findings provide tentative evidence consistent with a causal role of smoking on the development of schizophrenia in East Asian populations.
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Wang P, Abdin E, Asharani P, Seet V, Devi F, Roystonn K, Lee YY, Cetty L, Teh WL, Verma S, Mok YM, Subramaniam M. Nicotine Dependence in Patients with Major Depressive Disorder and Psychotic Disorders and Its Relationship with Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413035. [PMID: 34948665 PMCID: PMC8701186 DOI: 10.3390/ijerph182413035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022]
Abstract
The aim of the current study was to examine the associations between nicotine dependence and quality of life (QOL) among individuals diagnosed with major depressive disorder (MDD) or psychotic disorders. Methods: A total of 378 participants diagnosed with either MDD or psychotic disorders were recruited. The Fagerstorm Test for Nicotine Dependence was used to measure the level of nicotine dependence. The SF-12 health survey questionnaire was used to measure the QOL. Results: The prevalence of nicotine dependence was 23.3% in this sample population. For those diagnosed with MDD, moderate level of nicotine dependence was negatively associated with Vitality and Mental Component Score. For those diagnosed with a psychotic disorder high nicotine dependence was negatively associated with Role Emotional, Mental Health and Mental Component Score. Discussion: Compared to the general population, the prevalence of smoking in this psychiatric population was 2.4 times higher, while that of nicotine dependence was seven times higher. Individuals with psychotic disorder generally reported better QOL as compared to individuals with MDD. QOL differed across diagnostic groups with regards to socio-demographics, such as age, ethnicity, marital status, education, employment status and monthly income. Among individuals with MDD and psychotic disorders, different levels of nicotine dependence resulted in different levels of association with QOL. More research is needed to better understand the differences in QOL among the varying levels of nicotine dependence.
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Affiliation(s)
- Peizhi Wang
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Bunagkok View, Singapore 539747, Singapore; (E.A.); (P.V.A.); (V.S.); (F.D.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (M.S.)
- Correspondence:
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Bunagkok View, Singapore 539747, Singapore; (E.A.); (P.V.A.); (V.S.); (F.D.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (M.S.)
| | - P.V. Asharani
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Bunagkok View, Singapore 539747, Singapore; (E.A.); (P.V.A.); (V.S.); (F.D.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (M.S.)
| | - Vanessa Seet
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Bunagkok View, Singapore 539747, Singapore; (E.A.); (P.V.A.); (V.S.); (F.D.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (M.S.)
| | - Fiona Devi
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Bunagkok View, Singapore 539747, Singapore; (E.A.); (P.V.A.); (V.S.); (F.D.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (M.S.)
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Bunagkok View, Singapore 539747, Singapore; (E.A.); (P.V.A.); (V.S.); (F.D.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (M.S.)
| | - Ying Ying Lee
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Bunagkok View, Singapore 539747, Singapore; (E.A.); (P.V.A.); (V.S.); (F.D.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (M.S.)
| | - Laxman Cetty
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Bunagkok View, Singapore 539747, Singapore; (E.A.); (P.V.A.); (V.S.); (F.D.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (M.S.)
| | - Wen Lin Teh
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Bunagkok View, Singapore 539747, Singapore; (E.A.); (P.V.A.); (V.S.); (F.D.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (M.S.)
| | - Swapna Verma
- Early Psychosis Intervention Programme, Institute of Mental Health, Singapore 539747, Singapore;
- Office of Education, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
| | - Yee Ming Mok
- Department of Mood and Anxiety, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore 539747, Singapore;
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Bunagkok View, Singapore 539747, Singapore; (E.A.); (P.V.A.); (V.S.); (F.D.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (M.S.)
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Fornaro M, Carvalho AF, De Prisco M, Mondin AM, Billeci M, Selby P, Iasevoli F, Berk M, Castle DJ, de Bartolomeis A. The prevalence, odds, predictors, and management of tobacco use disorder or nicotine dependence among people with severe mental illness: Systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 132:289-303. [PMID: 34838527 DOI: 10.1016/j.neubiorev.2021.11.039] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022]
Abstract
The prevalence, correlates, and management of tobacco use disorder (TUD) or nicotine dependence (ND) among people with severe mental illness (SMI), namely schizophrenia, bipolar disorder (BD), and major depressive disorder (MDD), remain unclear. Therefore, a systematic review and meta-analysis was conducted. Electronic databases were systematically searched from inception to July 12, 2020, for observational studies documenting the prevalence, odds, and correlates of TUD/ND among people with SMI; randomized controlled trials (RCTs) informing the management of TUD/ND in people with SMI were also included. Random-effects meta-analyses were conducted. Sources of heterogeneity were explored. Nineteen observational studies, including 7527 participants with SMI met inclusion criteria. TUD/ND co-occurred in 33.4-65% of people with SMI. Rates were higher among males. While bupropion and varenicline represent promising treatment opportunities for schizophrenia with TUD/ND, non-pharmacological interventions require further research, mainly for people with primary mood disorders. TUD/ND represent prevalent co-occurring conditions among people with SMI. Further well-designed RCTs are warranted to inform their management.
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Affiliation(s)
- Michele Fornaro
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - Andre F Carvalho
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Vic., Australia.
| | - Michele De Prisco
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - Anna Maria Mondin
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - Martina Billeci
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - Peter Selby
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Felice Iasevoli
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
| | - David Jonathan Castle
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada.
| | - Andrea de Bartolomeis
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy; Chair Staff for Health Education and Sustainable Development, UNESCO, Naples, Italy.
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King M, Jones R, Petersen I, Hamilton F, Nazareth I. Cigarette smoking as a risk factor for schizophrenia or all non-affective psychoses. Psychol Med 2021; 51:1373-1381. [PMID: 32148211 DOI: 10.1017/s0033291720000136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Smoking tobacco is regarded as an epiphenomenon in patients with schizophrenia when it may be causal. We aimed to examine whether smoking status is related to the onset of schizophrenia or the broader diagnosis of non-affective psychosis, including schizophrenia. METHODS We used data from The Health Improvement Network primary care database to identify people aged 15-24 between 1 January 2004 and 31 December 2009. We followed them until the earliest of: first diagnosis of schizophrenia (or psychosis), patient left the practice, practice left THIN, patient died or 31 December 2014. RESULTS In men, incidence rates for schizophrenia per 100 000 person years at risk were higher in smoking initiators (non-smoker who became a smoker during the study) than in non-smokers (adjusted IRR 1.94; 95% CI 1.29-2.91) and higher still in smokers (adjusted IRR 3.32; 95% CI 2.67-4.14). Among women, the incidence rate of schizophrenia was higher in smokers than in non-smokers (adjusted IRR 1.50; 95% CI 1.06-2.12), but no higher in smoking initiators than non-smokers. For non-affective psychosis, the pattern was similar for men but more evident in women where psychosis incidence rates were higher in smoking initiators (adjusted IRR 1.90; 95% CI 1.40-2.56) and in smokers (adjusted IRR 2.13; 95% CI 1.76-2.57) than in non-smokers. CONCLUSIONS We found an important and strong association between smoking and incidence of schizophrenia. Smoking may increase risk through as yet unknown pathways or smoking may share genetic risk with schizophrenia and non-affective psychoses.
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Affiliation(s)
- Michael King
- Division of Psychiatry, University College London, B Wing, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Rebecca Jones
- Division of Psychiatry, University College London, B Wing, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Irene Petersen
- Research Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, University College London, Upper 3rd Floor, Royal Free Campus, Rowland Hill Street, LondonNW3 2PF, UK
| | - Fiona Hamilton
- Research Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, University College London, Upper 3rd Floor, Royal Free Campus, Rowland Hill Street, LondonNW3 2PF, UK
| | - Irwin Nazareth
- Research Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, University College London, Upper 3rd Floor, Royal Free Campus, Rowland Hill Street, LondonNW3 2PF, UK
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20
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Cigarette Smoking and Schizophrenia: Etiology, Clinical, Pharmacological, and Treatment Implications. SCHIZOPHRENIA RESEARCH AND TREATMENT 2021; 2021:7698030. [PMID: 34938579 PMCID: PMC8687814 DOI: 10.1155/2021/7698030] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/25/2021] [Indexed: 11/18/2022]
Abstract
Recent data suggests that the prevalence of smoking in schizophrenia remains high. While reports suggest that smoking increases the risk of developing schizophrenia, the potential causative role of smoking in this relationship needs further investigation. Smokers with schizophrenia are more likely to have more intense positive symptoms and lower cognitive function, but diminished intensity of extrapyramidal side effects than nonsmoking patients with schizophrenia. They were also more likely to exhibit aggressive behaviour compared to nonsmokers, which could suggest higher levels of baseline aggression. The significant cost associated with regular tobacco expenditure can detract from investment in key domains. Large-scale trials have shown that pharmacotherapy for smoking cessation is effective and does not worsen the risk of developing neuropsychiatric symptoms compared to placebo. Electronic cigarette use among schizophrenia patients is high, and there is emerging evidence supportive of its efficacy. Future improvements include large-scale trials assessing the utility, efficacy, and safety of electronic cigarettes in schizophrenia patients.
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Asharani PV, Ling Seet VA, Abdin E, Siva Kumar FD, Wang P, Roystonn K, Lee YY, Cetty L, Teh WL, Verma S, Mok YM, Fung DSS, Chong SA, Subramaniam M. Smoking and Mental Illness: Prevalence, Patterns and Correlates of Smoking and Smoking Cessation among Psychiatric Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155571. [PMID: 32752263 PMCID: PMC7432787 DOI: 10.3390/ijerph17155571] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/22/2020] [Accepted: 07/29/2020] [Indexed: 12/16/2022]
Abstract
This study aims to understand (a) the prevalence and correlates of smoking in a psychiatric population, (b) factors that encourage smoking cessation, and (c) awareness towards cessation programmes. This study captured data (n = 380) through a modified version of the Global Adult Tobacco Survey (GATS). A descriptive analysis of the data was performed. The prevalence of smoking was 39.5% (n = 150) and 52.3% of the smokers were dependent on nicotine. More than half of the smokers had made at least one attempt to quit in the past 12 months and 56% reported no immediate plans to quit smoking. The awareness towards institutional smoking cessation programmes was fair (44%), with 49.7% of smokers having indicated that they were willing to use the service upon referral. Smokers endorsed that increasing the cost of cigarettes, restricting availability, and increasing knowledge of health harms could encourage smoking cessation. Past smokers reported that self-determination/willpower followed by substitution of smoking with other types of foods and drinks were factors that helped them achieve successful cessation. Given that the readiness to quit and awareness towards cessation programmes are low among the smokers, concerted efforts through educational programmes and policy changes are crucial to achieve successful cessation.
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Affiliation(s)
- P. V. Asharani
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (V.A.L.S.); (E.A.); (F.D.S.K.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
- Correspondence: ; Tel.: +65-63892961
| | - Vanessa Ai Ling Seet
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (V.A.L.S.); (E.A.); (F.D.S.K.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (V.A.L.S.); (E.A.); (F.D.S.K.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Fiona Devi Siva Kumar
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (V.A.L.S.); (E.A.); (F.D.S.K.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Peizhi Wang
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (V.A.L.S.); (E.A.); (F.D.S.K.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (V.A.L.S.); (E.A.); (F.D.S.K.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Ying Ying Lee
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (V.A.L.S.); (E.A.); (F.D.S.K.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Laxman Cetty
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (V.A.L.S.); (E.A.); (F.D.S.K.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (V.A.L.S.); (E.A.); (F.D.S.K.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Swapna Verma
- Early Psychosis Intervention Programme, Institute of Mental Health, Singapore 539747, Singapore;
| | - Yee Ming Mok
- Department of Mood and Anxiety, Institute of Mental Health, Singapore 539747, Singapore;
| | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (V.A.L.S.); (E.A.); (F.D.S.K.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (V.A.L.S.); (E.A.); (F.D.S.K.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
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One-day tropisetron treatment improves cognitive deficits and P50 inhibition deficits in schizophrenia. Neuropsychopharmacology 2020; 45:1362-1368. [PMID: 32349117 PMCID: PMC7297960 DOI: 10.1038/s41386-020-0685-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 11/08/2022]
Abstract
The core features of schizophrenia (SCZ) include cognitive deficits and impaired sensory gating represented by P50 inhibition deficits, which appear to be related to the α7 nicotinic acetylcholine receptor (nAChR). An agonist of nAChR receptor may improve these defects. This study aimed to investigate how administering multiple doses of tropisetron, a partial agonist of nAChR, for 1 day would affect cognitive deficits and P50 inhibition deficits in SCZ patients. We randomized 40 SCZ non-smokers into a double-blind clinical trial with four groups: placebo, 5 mg/d, 10 mg/d, and 20 mg/d of oral tropisetron. Their P50 ratios were all more than 0.5 and they took risperidone at 3-6 mg/day for at least a month before participating in the experiment. We measured the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and P50 inhibition before and one day after treatment. After one day of treatment, the total RBANS scores of the 20 mg and 5 mg tropisetron groups, and the immediate memory of the 10 mg group were significantly higher than placebo group. The P50 ratio was smaller in the 5 mg and 10 mg groups than in the placebo group (both p < 0.05) after treatment. Furthermore, the improvement in RBANS total score was correlated with increased S1 latency (p < 0.05), and the increase in immediate memory score was correlated with decreased S2 amplitude. One day of treatment with tropisetron improved both cognitive and P50 inhibition deficits, suggesting that longer term treatment with α7 nAChR agonists for these deficits in SCZ may be promising.
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Fan YS, Yang S, Li Z, Li J, Guo X, Han S, Guo J, Duan X, Cui Q, Du L, Liao W, Chen H. A temporal chronnectomic framework: Cigarette smoking preserved the prefrontal dysfunction in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109860. [PMID: 31927054 DOI: 10.1016/j.pnpbp.2020.109860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 01/07/2020] [Accepted: 01/07/2020] [Indexed: 01/30/2023]
Abstract
The widespread cigarette smoking behavior in schizophrenia is generally attributed to its alleviation of patients' symptomatology by the self-medication hypothesis. The prefrontal cortex (PFC), which predominantly supports orchestrating thoughts and actions, might underlie the biological underpinnings of smoking behavior in schizophrenia. However, few studies have focused on the impact of smoking on the prefrontal function in schizophrenia. This study assumed that smoking-related alterations on the prefrontal dynamics of information integration (chronnectome) were different between healthy control (HC) and schizophrenia patient (SP). We recruited SP smokers (N = 22)/nonsmokers (N = 27) and HC smokers (N = 22)/nonsmokers (N = 21) who underwent resting-state functional magnetic resonance imaging (rsfMRI) with a total of 240 volumes (lasting for 480 s). We employed a chronnectomic density analysis on the rsfMRI signal by using a sliding-window method. We examined the interaction effect between smoking status and diagnosis utilizing two-way analysis of covariance under permutation test. Whereas disease-related reduced effects were found on the bilateral dorsolateral PFC chronnectomic density, no smoking effect was observed. As regards interaction effect, a smoking-related reduced effect was found on the right dorsolateral PFC chronnectomic density in HC, while a smoking-related increased effect was observed in SP. Nevertheless, post-hoc analysis revealed significant group difference between SP smokers and HC nonsmokers. Therefore, these results indicated a smoking-related preservation effect on disrupted prefrontal dynamics in schizophrenia that cannot restore it to normal levels. The novel findings yield a prefrontal-based chronnectome framework to elaborate upon the self-medication hypothesis in schizophrenia.
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Affiliation(s)
- Yun-Shuang Fan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Siqi Yang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Zehan Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Jiao Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Xiaonan Guo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Shaoqiang Han
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Jing Guo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Xujun Duan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Qian Cui
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Lian Du
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China
| | - Wei Liao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China..
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China..
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Kugathasan P, Wu H, Gaughran F, Nielsen RE, Pritchard M, Dobson R, Stewart R, Stubbs B. Association of physical health multimorbidity with mortality in people with schizophrenia spectrum disorders: Using a novel semantic search system that captures physical diseases in electronic patient records. Schizophr Res 2020; 216:408-415. [PMID: 31787481 DOI: 10.1016/j.schres.2019.10.061] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 06/22/2019] [Accepted: 10/31/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Single physical comorbidities have been associated with the premature mortality in people with schizophrenia-spectrum disorders (SSD). We investigated the association of physical multimorbidity (≥two physical health conditions) with mortality in people with SSD. METHODS A retrospective cohort study between 2013 and 2017. All people with a diagnosis of SSD (ICD-10: F20-F29), who had contact with secondary mental healthcare within South London during 2011-2012 were included. A novel semantic search system captured conditions from electronic mental health records, and all-cause mortality were retrieved. Hazard ratios (HRs) and population attributable fractions (PAFs) were calculated for associations between physical multimorbidity and all-cause mortality. RESULTS Among the 9775 people with SSD (mean (SD) age, 45.9 (15.4); males, 59.3%), 6262 (64%) had physical multimorbidity, and 880 (9%) died during the 5-year follow-up. The top three physical multimorbidity combinations with highest mortality were cardiovascular-respiratory (HR: 2.23; 95% CI, 1.49-3.32), respiratory-skin (HR: 2.06; 95% CI, 1.31-3.24), and respiratory-digestive (HR: 1.88; 95% CI, 1.14-3.11), when adjusted for age, gender, and all other physical disease systems. Combinations of physical diseases with highest PAFs were cardiovascular-respiratory (PAF: 35.7%), neurologic-respiratory (PAF: 32.7%), as well as respiratory-skin (PAF: 29.8%). CONCLUSIONS Approximately 2/3 of patients with SSD had physical multimorbidity and the risk of mortality in these patients was further increased compared to those with none or single physical conditions. These findings suggest that in order to reduce the physical health burden and subsequent mortality in people with SSD, proactive coordinated prevention and management efforts are required and should extend beyond the current focus on single physical comorbidities.
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Affiliation(s)
- Pirathiv Kugathasan
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Honghan Wu
- Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Scotland, United Kingdom
| | - Fiona Gaughran
- King's College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), De Crespigny Park, London, United Kingdom; South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom
| | - René Ernst Nielsen
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Megan Pritchard
- King's College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), De Crespigny Park, London, United Kingdom; South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom
| | - Richard Dobson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Health Data Research UK London, Institute of Health Informatics, University College London, London, United Kingdom
| | - Robert Stewart
- King's College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), De Crespigny Park, London, United Kingdom; South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom
| | - Brendon Stubbs
- King's College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), De Crespigny Park, London, United Kingdom; South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom.
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The D2-family receptor agonist bromocriptine but, not nicotine, reverses NMDA receptor antagonist-induced working memory deficits in the radial arm maze in mice. Neurobiol Learn Mem 2020; 168:107159. [PMID: 31911198 DOI: 10.1016/j.nlm.2020.107159] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 12/10/2019] [Accepted: 01/03/2020] [Indexed: 11/22/2022]
Abstract
Hypofunction of the NMDA receptor (NMDAr) may underlie cognitive deficits associated with schizophrenia and other psychiatric conditions including working memory (WM) impairments. Given that these deficits link closely to functional outcome, treatments remediating such deficits require identification. NMDAr hypofunction can be modeled via treatment with the antagonist MK-801. Hence, the present study determined whether cholinergic or dopaminergic agonists attenuate MK-801-induced WM deficits in mice. WM was assessed in male C57BL/6 mice trained on an automated 12-arm radial arm maze (RAM) paradigm, wherein rewards were delivered after the first but, not after subsequent entries into WM arms (8/12) and never delivered for entries into reference memory (RM) arms (4/12). Mice were then treated with MK-801 (vehicle or 0.3 mg/kg) and nicotine (vehicle, 0.03 or 0.30 mg/kg) in a cross-over design. After a 2-week washout, mice were then retested with MK-801 and the dopamine D2-family receptor agonist bromocriptine (vehicle, 3 or 10 mg/kg). In both experiments, MK-801 reduced WM span and increased RM and WM error rates. Nicotine did not attenuate these deficits. In contrast, a bromocriptine/MK-801 interaction was observed on WM error rate, where bromocriptine attenuated MK-801 induced deficits without affecting MK-801-induced RM errors. Additionally, bromocriptine produced the main effect of slowing latency to collect rewards. Hence, while NMDAr hypofunction-induced deficits in WM was unaffected by nicotine, it was remediated by treatment with the dopamine D2-family agonist bromocriptine. Future studies should determine whether selective activation of dopamine D2, D3, or D4 receptors remediate this NMDAr hypofunction-induced WM deficit.
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Tzur Bitan D, Berzin D, Cohen A. Hidradenitis suppurativa and schizophrenia: a nationwide cohort study. J Eur Acad Dermatol Venereol 2019; 34:574-579. [DOI: 10.1111/jdv.15997] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 09/25/2019] [Indexed: 12/18/2022]
Affiliation(s)
- D. Tzur Bitan
- Department of Behavioral Sciences Ariel University Ariel Israel
- Shalvata Mental Health Center Affiliated with the Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - D. Berzin
- School of Medicine Ben‐Gurion University of the Negev Be'er Sheva Israel
| | - A.D. Cohen
- Chief Physician's Office Clalit Health Services Tel Aviv Israel
- Siaal Research Center for Family Medicine and Primary Care Faculty of Health Sciences Ben‐Gurion University of the Negev Be'er Sheva Israel
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Liao W, Fan YS, Yang S, Li J, Duan X, Cui Q, Chen H. Preservation Effect: Cigarette Smoking Acts on the Dynamic of Influences Among Unifying Neuropsychiatric Triple Networks in Schizophrenia. Schizophr Bull 2019; 45:1242-1250. [PMID: 30561724 PMCID: PMC6811814 DOI: 10.1093/schbul/sby184] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The high prevalence of cigarette smoking in schizophrenia (SZ) is generally explained by the self-medication theory. However, its neurobiological mechanism remains unclear. The impaired dynamic of influences among unifying neuropsychiatric triple networks in SZ, including the central executive network (CEN), the default mode network (DMN), and the salience network (SN), might explain the nature of their syndromes, whereas smoking could regulate the dynamics within networks. Therefore, this study examined whether cigarette smoking could elicit a distinct improvement in the dynamics of triple networks in SZ and associated with the alleviation of symptoms. METHODS Four groups were recruited, namely, SZ smoking (n = 22)/nonsmoking (n = 25), and healthy controls smoking (n = 22)/nonsmoking (n = 21). All participants underwent a resting-state functional magnetic resonance imaging (fMRI). The dynamics among unifying neuropsychiatric triple networks were measured using Granger causality analysis on the resting-sate fMRI signal. Interaction effects between SZ and smoking on dynamics were detected using 2-way analysis of covariance, correcting for sex, age, and education level. RESULTS Whereas smoking reduced SN→DMN dynamic in healthy controls, it preserved the dynamic in SZ, thus suggesting a preservation effect. Moreover, smoking additionally increased DMN→CEN dynamic in SZ. CONCLUSIONS This finding from neural pathways shed new insights into the prevailing self-medication hypothesis in SZ. More broadly, this study elaborates on the neurobiological dynamics that may assist in the treatment of the symptomatology of SZ.
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Affiliation(s)
- Wei Liao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, P.R. China
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, P.R. China
| | - Yun-Shuang Fan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, P.R. China
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, P.R. China
| | - Siqi Yang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, P.R. China
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, P.R. China
| | - Jiao Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, P.R. China
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, P.R. China
| | - Xujun Duan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, P.R. China
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, P.R. China
| | - Qian Cui
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, P.R. China
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, P.R. China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, P.R. China
- School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, P.R. China
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Krieger I, Tzur Bitan D, Comaneshter D, Cohen A, Feingold D. Increased risk of smoking-related illnesses in schizophrenia patients: A nationwide cohort study. Schizophr Res 2019; 212:121-125. [PMID: 31395488 DOI: 10.1016/j.schres.2019.07.058] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/23/2019] [Accepted: 07/29/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND Schizophrenia patients smoke at three times the rate of the general population, and are more susceptible to smoking-related illnesses. The goal of the current study was to evaluate the cumulative probability of chronic obstructive pulmonary disease (COPD) and ischemic heart disease (IHD) following first documentation of smoking among schizophrenia patients as compared to smoking healthy controls. METHODS A nationally representative cohort study was designed to assess the odds and cumulative probability of COPD and IHD among individuals with schizophrenia (n = 10,502) and a matched-sample of smoking healthy controls (n = 10,502). Hierarchical logistic regressions and Kaplan-Meier regression models were used to compare odds and cumulative probabilities across the two groups. RESULTS After adjusting for clinical and demographic factors, smoking schizophrenia patients had a higher probability of receiving a diagnosis of COPD than smoking healthy controls (OR 2.14, 95%CI 1.51-3.01, p < 0.001). The probability of having COPD increased more rapidly in smoking schizophrenia patients, yet the opposite trajectory prevailed for IHD, showing a decreased cumulative probability in smoking schizophrenia patients compared to smoking healthy controls. DISCUSSION Schizophrenia has a unique contribution to the facilitation of COPD, which extends beyond the effect of smoking, or other clinical and demographic risk factors. Differential smoking patterns could potentially account for this effect. The differential pattern of IHD should be subjected to further research, as our results might indicate that schizophrenia patients are underdiagnosed with IHD, and may be even less diagnosed as a function of time and chronicity.
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Affiliation(s)
- Israel Krieger
- Shalvata Mental Health Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Aliat Hanoar 13, Hod Hasharon, Israel
| | - Dana Tzur Bitan
- Department of Behavioral Sciences, Ariel University, 40700, Israel; Shalvata Mental Health Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Aliat Hanoar 13, Hod Hasharon, Israel.
| | - Doron Comaneshter
- Chief Physician's Office, Clalit Health Services, Dov Hos 1, Tel Aviv, Israel
| | - Arnon Cohen
- Chief Physician's Office, Clalit Health Services, Dov Hos 1, Tel Aviv, Israel; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Daniel Feingold
- Department of Behavioral Sciences, Ariel University, 40700, Israel
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Lecca S, Luchicchi A, Scherma M, Fadda P, Muntoni AL, Pistis M. Δ 9-Tetrahydrocannabinol During Adolescence Attenuates Disruption of Dopamine Function Induced in Rats by Maternal Immune Activation. Front Behav Neurosci 2019; 13:202. [PMID: 31551729 PMCID: PMC6743372 DOI: 10.3389/fnbeh.2019.00202] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 08/19/2019] [Indexed: 01/29/2023] Open
Abstract
The combination of prenatal, such as maternal infections, and postnatal environmental insults (e.g., adolescent drug abuse) increases risks for psychosis, as predicted by the two-hit hypothesis of schizophrenia. Cannabis abuse during adolescence is widespread and is associated with increased risk of psychoses later in life. Here, we hypothesized that adolescent Δ9-tetrahydrocannabinol (THC) worsens the impact of prenatal maternal immune activation (MIA) on ventral tegmental area (VTA) dopamine cells in rat offspring. Additionally, since substance abuse disorder is particularly prevalent among schizophrenia patients, we also tested how VTA dopamine neurons in MIA offspring respond to acute nicotine and cocaine administration. We used a model of neurodevelopmental disruption based on prenatal administration of the polyriboinosinic-polyribocytidilic acid [poly (I:C)] in rats, which activates the maternal immune system by mimicking a viral infection and induces behavioral abnormalities and disruption of dopamine transmission relevant to psychiatric disorders in the offspring. Male offspring were administered THC (or vehicle) during adolescence (PND 45–55). Once adult (PND 70–90), we recorded the spontaneous activity of dopamine neurons in the VTA and their responses to nicotine and cocaine. MIA male offspring displayed reduced number, firing rate and altered activity pattern of VTA dopamine cells. Adolescent THC attenuated several MIA-induced effects. Both prenatal [poly (I:C)] and postnatal (THC) treatments affected the response to nicotine but not to cocaine. Contrary to our expectations, adolescent THC did not worsen MIA-induced deficits. Results indicate that the impact of cannabinoids in psychosis models is complex.
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Affiliation(s)
- Salvatore Lecca
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, Italy
| | - Antonio Luchicchi
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, Italy
| | - Maria Scherma
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, Italy
| | - Paola Fadda
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, Italy.,Section of Cagliari, Neuroscience Institute, National Research Council of Italy (CNR), Monserrato, Italy
| | - Anna Lisa Muntoni
- Section of Cagliari, Neuroscience Institute, National Research Council of Italy (CNR), Monserrato, Italy
| | - Marco Pistis
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, Italy.,Section of Cagliari, Neuroscience Institute, National Research Council of Italy (CNR), Monserrato, Italy
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Yang S, Meng Y, Li J, Fan YS, Du L, Chen H, Liao W. Temporal dynamic changes of intrinsic brain activity in schizophrenia with cigarette smoking. Schizophr Res 2019; 210:66-72. [PMID: 31239219 DOI: 10.1016/j.schres.2019.06.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 05/05/2019] [Accepted: 06/17/2019] [Indexed: 10/26/2022]
Abstract
Mounting evidence from multimodal neuroimaging studies has supported a neurobiological basis for schizophrenia-nicotine dependence comorbidity. However, this evidence comes exclusively from studies measuring static intrinsic activity/connectivity of the brain, while the dynamic effects of this comorbidity remain poorly understood. The current study therefore sought to examine whether temporal dynamic intrinsic brain activity interacted with diagnosis (schizophrenics vs. healthy controls) and smoking status (smokers vs. non-smokers). We used a mixed sample design and included the following four groups: i) schizophrenic smokers (n = 22), ii) schizophrenic non-smokers (n = 27), iii) healthy control smokers (n = 22), and iv) healthy control non-smokers (n = 21). All subjects underwent functional magnetic resonance imaging during the resting state. The temporal variability in intrinsic brain activity among the four groups was compared using a novel dynamic amplitude of low-frequency fluctuation (dALFF) method. A significant main effect of diagnosis was found in the left superior parietal gyrus (SPG; F(1, 88) = 142.1, P < 0.0001). Moreover, the dALFF strength in the SPG was positively correlated with disease duration in patients with schizophrenia (Rho(46) = 0.43, P = 0.002). In addition, a significant interaction between diagnosis and smoking status was observed in the left dorsolateral prefrontal cortex (DLPFC; F(1, 88) = 7.39, P = 0.008), which was consistent with the self-medication hypothesis. Together, this study has demonstrated for the first time that nicotine restores dynamic intrinsic brain activity in the left DLPFC in patients with schizophrenia. This interaction may be a clinical neuromarker for increased comorbid smoking in schizophrenia.
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Affiliation(s)
- Siqi Yang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 610054, PR China; School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Yao Meng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 610054, PR China; School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Jiao Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 610054, PR China; School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Yun-Shuang Fan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 610054, PR China; School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Lian Du
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 610054, PR China; School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Wei Liao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 610054, PR China; School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu 610054, PR China.
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de la Salle S, Inyang L, Impey D, Smith D, Choueiry J, Nelson R, Heera J, Baddeley A, Ilivitsky V, Knott V. Acute separate and combined effects of cannabinoid and nicotinic receptor agonists on MMN-indexed auditory deviance detection in healthy humans. Pharmacol Biochem Behav 2019; 184:172739. [PMID: 31283908 DOI: 10.1016/j.pbb.2019.172739] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 12/21/2022]
Abstract
The high prevalence of concomitant cannabis and nicotine use has implications for sensory and cognitive processing. While nicotine tends to enhance function in these domains, cannabis use has been associated with both sensory and cognitive impairments, though the underlying mechanisms are unclear. Additionally, the interaction of the nicotinic (nAChR) and cannabinoid (CB1) receptor systems has received limited study in terms of sensory/cognitive processes. This study involving healthy volunteers assessed the acute separate and combined effects of nabilone (a CB1 agonist) and nicotine on sensory processing as assessed by auditory deviance detection and indexed by the mismatch negativity (MMN) event-related potential. It was hypothesized that nabilone would impair auditory discriminability as shown by diminished MMN amplitudes, but not when administered in combination with nicotine. 20 male non-smokers and non-cannabis-users were assessed using a 5-stimulus 'optimal' multi-feature MMN paradigm within a randomized, placebo controlled design (placebo; nabilone [0.5 mg]; nicotine [6 mg]; and nicotine + nabilone). Treatment effects were region- and deviant-dependent. At the temporal regions (mastoid sites), MMN was reduced by nabilone and nicotine separately, whereas co-administration resulted in no impairment. At the frontal region, MMN was enhanced by co-administration of nicotine and nabilone, with no MMN effects being found with separate treatment. These neural effects have relevance for sensory/cognitive processes influenced by separate and simultaneous use of cannabis and tobacco and may have treatment implications for disorders associated with sensory dysfunction and impairments in endocannabinoid and nicotinic cholinergic neurotransmission.
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Affiliation(s)
- Sara de la Salle
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Lawrence Inyang
- Interdisciplinary Sciences, Carleton University, Ottawa, ON, Canada
| | - Danielle Impey
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Dylan Smith
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Joelle Choueiry
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Renee Nelson
- Biomedical Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Jasmit Heera
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Ashley Baddeley
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Vadim Ilivitsky
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Verner Knott
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada; Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
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Huang H, Dong M, Zhang L, Zhong BL, Ng CH, Ungvari GS, Yuan Z, Meng X, Xiang YT. Psychopathology and extrapyramidal side effects in smoking and non-smoking patients with schizophrenia: Systematic review and meta-analysis of comparative studies. Prog Neuropsychopharmacol Biol Psychiatry 2019; 92:476-482. [PMID: 30794823 DOI: 10.1016/j.pnpbp.2019.02.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 02/12/2019] [Accepted: 02/17/2019] [Indexed: 12/21/2022]
Abstract
The association between smoking and psychopathology and extrapyramidal side effects (EPSE) in schizophrenia has been controversial. This systematic review and meta-analysis compared psychopathology and EPSE between smoking and non-smoking schizophrenia patients. The PubMed, EMBASE, PsycINFO, Cochrane Library, and Web of Science databases were independently and systematically searched by two researchers to identify relevant articles. Standardized mean differences (SMDs) and their 95% confidence intervals (CI) were calculated with random effect models. Subgroup and meta-regression analyses were performed to explore sources of heterogeneity. The systematic review and meta-analysis included 29 studies that compared psychotic, depressive and anxiety symptoms and EPSE between smoking (n = 3591) and non-smoking schizophrenia patients (n = 2980). Smoking patients had significantly more severe positive symptoms (24 studies; SMD = 0.33, 95% CI: 0.16 to 0.50, P < 0.001), but less severe EPSE (7 studies; SMD = -0.20, 95% CI: -0.38 to -0.02, P = 0. 03). No significant group differences in negative, depressive and anxiety symptoms were found. In conclusion, this systematic review and meta-analysis found that smoking schizophrenia patients had more severe positive symptoms but less severe EPSE than non-smoking patients.
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Affiliation(s)
- Hui Huang
- Affiliated Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Min Dong
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, the Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, School of Mental Health, Capital Medical University, Beijing, China
| | - Bao-Liang Zhong
- Affiliated Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Zhen Yuan
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Xiangfei Meng
- Department of Psychiatry, McGill University and the Douglas Mental Health University Institute, Montreal, Canada
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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Density of small dendritic spines and microtubule-associated-protein-2 immunoreactivity in the primary auditory cortex of subjects with schizophrenia. Neuropsychopharmacology 2019; 44:1055-1061. [PMID: 30795003 PMCID: PMC6461932 DOI: 10.1038/s41386-019-0350-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/15/2019] [Accepted: 02/16/2019] [Indexed: 12/22/2022]
Abstract
Previously, we demonstrated that dendritic spine density (DSD) in deep layer 3 of the primary auditory cortex (A1) is lower, due to having fewer small spines, in subjects with schizophrenia (SZ) than non-psychiatric control (NPC) subjects. We also previously demonstrated that microtubule-associated-protein-2 immunoreactivity (MAP2-IR) in A1 deep layer 3 is lower, and positively correlated with DSD, in SZ subjects. Here, we first sought to confirm these findings in an independent cohort of 25 SZ-NPC subject pairs (cohort 1). We used immunohistochemistry and confocal microscopy to measure DSD and MAP2-IR in A1 deep layer 3. Consistent with previous studies, both DSD and MAP2-IR were lower in SZ subjects. We then tested the hypothesis that MAP2-IR mediates the effect of SZ on DSD in a cohort of 45 SZ-NPC subject pairs (combined cohort) that included all subjects from cohort 1 and two previously studied cohorts. Based on the distribution of MAP2-IR values in NPC subjects, we categorized each SZ subject as having either low MAP2-IR (SZ MAP2-IR(low)) or normal MAP2-IR (SZ MAP2-IR(normal)). Among SZ MAP-IR(low) subjects, mean DSD was significantly lower than in NPC subjects. However, mean DSD did not differ between SZ MAP2-IR(normal) and NPC subjects. Moreover, MAP2-IR statistically mediated small spine differences, with lower MAP2-IR values associated with fewer small spines. Our findings confirm that low density of small spines and low MAP2-IR are robust SZ phenotypes and suggest that MAP2-IR mediates the effect of SZ on DSD.
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Oliveira RMD, Santos JLF, Furegato ARF. Prevalence and smokers' profile: comparisons between the psychiatric population and the general population. Rev Lat Am Enfermagem 2019; 27:e3149. [PMID: 31038640 PMCID: PMC6528629 DOI: 10.1590/1518-8345.2976.3149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 02/07/2019] [Indexed: 11/21/2022] Open
Abstract
Objectives: to identify the prevalence of smokers between the psychiatric population and
the general population; to compare the personal, socio-demographic and
clinical profile of smokers and non-smokers in the psychiatric population
and the general population; to compare the reasons for smoking of these two
population groups. Method: this is a cross-sectional descriptive-analytical epidemiological study with
378 patients from three services: Ambulatory Mental Health, Psychiatric
Hospital, and Basic Health Unit. Interviews were conducted with three
questionnaires. The Chi-square and Kruskal-Wallis tests were applied. Results: in the total of the 378 participants, 67% were women and 69% were over 40
years old. There was a higher prevalence of smokers among men, young people,
illiterates, singles and with more than one government benefit. Smokers
prevailed among schizophrenics, chronic patients, who used ≥ 3 psychotropic
drugs and had a history of ≥ 4 psychiatric hospitalizations and/or suicide
attempts. The main reason for smoking was the improvement of negative
feelings. Conclusion: the prevalence of smokers is higher in the psychiatric population (especially
among severely ill patients) and among men, young people, unmarried and with
socioeconomic losses. The main reason for smoking is tension/relaxation
relief. This study provides nurses and other professionals with knowledge
capable of subsidizing the planning of smoking interventions in the
Brazilian population.
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Affiliation(s)
| | | | - Antonia Regina Ferreira Furegato
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
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Wang YY, Wang S, Zheng W, Zhong BL, Ng CH, Ungvari GS, Wang CX, Xiang YT, Li XH. Cognitive functions in smoking and non-smoking patients with schizophrenia: A systematic review and meta-analysis of comparative studies. Psychiatry Res 2019; 272:155-163. [PMID: 30583258 DOI: 10.1016/j.psychres.2018.12.064] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/19/2018] [Accepted: 12/10/2018] [Indexed: 11/18/2022]
Abstract
The "Self-medication hypothesis" that has been developed to explain the effect of nicotine in improving aspects of cognitive impairment in schizophrenia remains controversial. This systematic review and meta-analysis compared cognitive functions between smoking and non-smoking schizophrenia patients. The PubMed, PsycINFO, EMBASE, Web of Science, and Cochrane Library databases were systematically and independently searched. Basic demographic and clinical characteristics, smoking history and cognitive performance were recorded. Seven of the 11 studies included in the study, had meta-analyzable data. Compared to non-smoking schizophrenia patients, their smoking counterparts showed significant deficits on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)-immediate memory (n = 739), the RBANS-total score (n = 739) and the Continuous Performance Test-Identical Pairs (n = 157). Two of the 4 studies without meta-analysable data did not report significant group difference in performance on the Wechsler Digit Span Task and the Beck Cognitive Insight Scale, while the other 2 studies found that non-smokers outperformed than smokers in problem solving and visual learning. In conclusion, this systematic review and meta-analysis found that smoking schizophrenia patients had worse performance in certain cognitive tasks than non-smoking patients, casting doubts on the validity of the "self-medication hypothesis" that needs to be further examined.
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Affiliation(s)
- Yuan-Yuan Wang
- Faculty of Health and Life Sciences, De Montfort University, Leicester, UK; Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Shuo Wang
- Neurology Center, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; Department of Neuropsychiatry & Behavioral Neurology and Clinical Psychology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Bao-Liang Zhong
- The Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Gabor S Ungvari
- Section of Psychiatry, University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, Medical School, University of Western Australia, Perth, Australia
| | - Chun-Xue Wang
- Neurology Center, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; Department of Neuropsychiatry & Behavioral Neurology and Clinical Psychology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
| | - Xiao-Hong Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, China.
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Maideen NMP. Tobacco smoking and its drug interactions with comedications involving CYP and UGT enzymes and nicotine. World J Pharmacol 2019; 8:14-25. [DOI: 10.5497/wjp.v8.i2.14] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/20/2019] [Accepted: 01/28/2019] [Indexed: 02/06/2023] Open
Abstract
Tobacco smoking is a global public health threat causing several illnesses including cardiovascular disease (Myocardial infarction), cerebrovascular disease (Stroke), peripheral vascular disease (Claudication), chronic obstructive pulmonary disease, asthma, reduced female infertility, sexual dysfunction in men, different types of cancer and many other diseases. It has been estimated in 2015 that approximately 1.3 billion people smoke, around the globe. Use of medications among smokers is more common, nowadays. This review is aimed to identify the medications affected by smoking, involving Cytochrome P450 (CYP) and uridine diphosphate-glucuronosyltransferases (UGTs) enzymes and Nicotine. Polycyclic aromatic hydrocarbons (PAHs) of tobacco smoke have been associated with the induction of CYP enzymes such as CYP1A1, CYP1A2 and possibly CYP2E1 and UGT enzymes. The drugs metabolized by CYP1A1, CYP1A2, CYP2E1 and UGT enzymes might be affected by tobacco smoking and the smokers taking medications metabolized by those enzymes, may need higher doses due to decreased plasma concentrations through enhanced induction by PAHs of tobacco smoke. The prescribers and the pharmacists are required to be aware of medications affected by tobacco smoking to prevent the toxicity-associated complications during smoking cessation.
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Potvin S, Dugré JR, Fahim C, Dumais A. Increased Connectivity Between the Nucleus Accumbens and the Default Mode Network in Patients With Schizophrenia During Cigarette Cravings. J Dual Diagn 2019; 15:8-15. [PMID: 30445892 DOI: 10.1080/15504263.2018.1526432] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Compared to the general population, tobacco smoking cessation rates are lower in populations with schizophrenia. Unfortunately, the potential neurophysiologic mechanisms underlying these low cessation rates in schizophrenia have been seldom studied using functional neuroimaging. Recently, it has been shown that tobacco cravings are increased in smokers with schizophrenia compared to smokers with no comorbid psychiatric disorder. Given the critical role of the brain reward system in the neurobiology of addiction, we sought to examine the functional connectivity of core regions of this system in smokers with schizophrenia during the viewing of appetitive smoking cues. Methods: Smokers with (n = 18) and without (n = 24) schizophrenia were scanned using functional magnetic resonance imaging while viewing appetitive cigarette images. Functional connectivity analyses were performed using the bilateral nucleus accumbens as the seed regions. Results: Smokers with schizophrenia and smokers with no psychiatric comorbidity did not differ in subjective cravings in response to appetitive smoking cues. However, in smokers with schizophrenia relative to control smokers, we found an increased connectivity between the nucleus accumbens and regions involved in the default mode network (e.g., middle temporal gyrus and precuneus), which are involved in self-referential processes. Moreover, a positive correlation was observed between the left nucleus accumbens and left middle temporal gyrus connectivity and cigarette cravings across both groups of smokers. Conclusions: These results highlight a key role of the nucleus accumbens in cigarette craving in schizophrenia and suggest that the subjective valuation of cigarette cues is increased in this population. Similar neurofunctional studies on cravings for other psychoactive substances in schizophrenia are warranted.
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Affiliation(s)
- Stéphane Potvin
- a Centre de Recherche de l'Institut , Universitaire en Santé Mentale de Montréal , Montréal , Canada.,b Department of Psychiatry , University of Montreal , Montreal , Canada
| | - Jules R Dugré
- a Centre de Recherche de l'Institut , Universitaire en Santé Mentale de Montréal , Montréal , Canada.,b Department of Psychiatry , University of Montreal , Montreal , Canada
| | - Cherine Fahim
- a Centre de Recherche de l'Institut , Universitaire en Santé Mentale de Montréal , Montréal , Canada.,b Department of Psychiatry , University of Montreal , Montreal , Canada.,c Centre de Recherche du CHU Ste-Justine , Montreal , Canada
| | - Alexandre Dumais
- a Centre de Recherche de l'Institut , Universitaire en Santé Mentale de Montréal , Montréal , Canada.,b Department of Psychiatry , University of Montreal , Montreal , Canada.,d Institut Philippe-Pinel de Montréal , Montreal , Canada
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Lucatch AM, Lowe DJE, Clark RC, Kozak K, George TP. Neurobiological Determinants of Tobacco Smoking in Schizophrenia. Front Psychiatry 2018; 9:672. [PMID: 30574101 PMCID: PMC6291492 DOI: 10.3389/fpsyt.2018.00672] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 11/21/2018] [Indexed: 12/22/2022] Open
Abstract
Purpose of review: To provide an overview of the underlying neurobiology of tobacco smoking in schizophrenia, and implications for treatment of this comorbidity. Recent findings: Explanations for heavy tobacco smoking in schizophrenia include pro-cognitive effects of nicotine, and remediation of the underlying pathophysiology of schizophrenia. Nicotine may ameliorate neurochemical deficits through nicotine acetylcholine receptors (nAChRs) located on the dopamine, glutamate, and GABA neurons. Neurophysiological indices including electroencephalography, electromyography, and smooth pursuit eye movement (SPEM) paradigms may be biomarkers for underlying neuronal imbalances that contribute to the specific risk of tobacco smoking initiation, maintenance, and difficulty quitting within schizophrenia. Moreover, several social factors including socioeconomic factors and permissive smoking culture in mental health facilities, may contribute to the smoking behaviors (initiation, maintenance, and inability to quit smoking) within this disorder. Summary: Tobacco smoking may alleviate specific symptoms associated with schizophrenia. Understanding the neurobiological underpinnings and psychosocial determinants of this comorbidity may better explain these potential beneficial effects, while also providing important insights into effective treatments for smoking cessation.
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Affiliation(s)
- Aliya M. Lucatch
- Addictions Division, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Darby J. E. Lowe
- Addictions Division, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Rachel C. Clark
- Addictions Division, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Karolina Kozak
- Addictions Division, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Tony P. George
- Addictions Division, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Division and Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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39
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Nicotine in action: cigarette smoking modulated homotopic functional connectivity in schizophrenia. Brain Imaging Behav 2018; 13:1612-1623. [DOI: 10.1007/s11682-018-0001-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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40
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Hidese S, Matsuo J, Ishida I, Hiraishi M, Teraishi T, Ota M, Hattori K, Kunugi H. Association between lower estimated premorbid intelligence quotient and smoking behavior in patients with schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2018; 15:7-13. [PMID: 30310770 PMCID: PMC6176847 DOI: 10.1016/j.scog.2018.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 09/26/2018] [Accepted: 09/30/2018] [Indexed: 12/18/2022]
Abstract
Aim We aimed to investigate the involvement of premorbid intelligence quotient in higher prevalence of smoking in patients with schizophrenia. Methods Participants included 190 patients with schizophrenia (mean ± standard deviation age: 37.7 ± 10.8 years; 88 males and 102 females) and 312 healthy individuals (mean ± standard deviation age: 38.1 ± 13.8; 166 males and 146 females), matched for age, sex, and ethnicity (Japanese). Premorbid intelligence quotient was estimated using the Japanese Adult Reading Test and distress symptoms were assessed using the Hopkins Symptom Check List. Current smoking information was collected according to self-declarations. Results As expected, the smoking rate was higher, while mean education level and Japanese Adult Reading Test scores were significantly lower, in patients with schizophrenia than in healthy individuals (p < 0.01). The mean education level and Japanese Adult Reading Test scores were significantly lower in the smoker group than in the non-smoker group in both patients and healthy individuals (p < 0.05). In the patient group alone, Hopkins Symptom Check List subscale and total scores were significantly higher in the smoker group than in the non-smoker group (p < 0.05). A multivariate regression analysis showed that the Japanese Adult Reading Test score was a significant and negative predictor for smoking (p < 0.001, odds ratio = 0.97; 95% confidence interval: 0.96–0.99). Conclusion Our results suggest that lower estimated premorbid intelligence quotient is an important variable in elucidating smoking behavior in humans and may be associated with higher prevalence of smoking in patients with schizophrenia.
Lower premorbid intelligence quotient (IQ) was observed in patients with schizophrenia who were smokers. Lower education level was observed in patients with schizophrenia who were smokers. Lower premorbid IQ and education level were also seen in smokers in the healthy group. Distress symptoms were higher in smokers with schizophrenia. In total, premorbid IQ was a negative predictor for smoking.
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Key Words
- ANCOVA, Analysis of covariance
- CI, Confidence interval
- Distress symptom
- Education level
- HSCL, Hopkins Symptom Check List
- IQ, Intelligence quotient
- JART, Japanese Adult Reading Test
- MANCOVA, Multivariate analysis of covariance
- NART, National Adult Reading Test
- OR, Odds ratio
- PANSS, Positive and Negative Syndrome Scale
- PSQI, Pittsburgh Sleep Quality Index
- Premorbid intelligence quotient
- Schizophrenia
- Smoking
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Affiliation(s)
- Shinsuke Hidese
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Junko Matsuo
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Ikki Ishida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Moeko Hiraishi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Toshiya Teraishi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Miho Ota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Kotaro Hattori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
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Association of lifestyle-related factors and psychological factors on quality of life in people with schizophrenia. Psychiatry Res 2018; 267:382-393. [PMID: 29960260 DOI: 10.1016/j.psychres.2018.06.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 06/09/2018] [Accepted: 06/10/2018] [Indexed: 02/07/2023]
Abstract
In people with schizophrenia several factors are associated with poor quality of life (QoL), namely, lifestyle-related factors and psychological factors. However, there has been little research on the impact of these factors on QoL. Therefore, the relation between lifestyle-related factors, psychological factors, and QoL in people with schizophrenia was assessed. A cross-sectional study was conducted among 115 patients (25% women, 50% inpatients). QoL was measured by World Health Organisation Quality of Life- Brief Version. Lifestyle-related factors were assessed, namely physical activity (International Physical Activity Questionnaire- Short Form), sleep quality (Pittsburgh Sleep Quality Index) and dietary intake (Mediterranean Diet score). Psychological factors such as self-esteem (Rosenberg Self-Esteem Scale) and autonomous motivation (Behavioural Regulation Questionnaire- version 3) were also measured. Regression analyses were performed to identify significant predictors of QoL. Results showed that self-esteem predicted better global, physical, psychological and environmental QoL. Physical activity predicted better global and physical QoL, while sedentary time predicted poor social and environmental QoL. Identifying predictors of QoL has implication for the effective design and delivery of lifestyles interventions, including physical activity, dietary education and smoking cessation in people with schizophrenia. Adopting healthy lifestyles may lead to improved physical health, psychological well-being and QoL in this population.
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Kostrzewa RM, Wydra K, Filip M, Crawford CA, McDougall SA, Brown RW, Borroto-Escuela DO, Fuxe K, Gainetdinov RR. Dopamine D 2 Receptor Supersensitivity as a Spectrum of Neurotoxicity and Status in Psychiatric Disorders. J Pharmacol Exp Ther 2018; 366:519-526. [PMID: 29921706 PMCID: PMC6094354 DOI: 10.1124/jpet.118.247981] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/23/2018] [Indexed: 12/13/2022] Open
Abstract
Abnormality of dopamine D2 receptor (D2R) function, often observed as D2R supersensitivity (D2RSS), is a commonality of schizophrenia and related psychiatric disorders in humans. Moreover, virtually all psychotherapeutic agents for schizophrenia target D2R in brain. Permanent D2RSS as a feature of a new animal model of schizophrenia was first reported in 1991, and then behaviorally and biochemically characterized over the next 15-20 years. In this model of schizophrenia characterized by production of D2RSS in ontogeny, there are demonstrated alterations of signaling processes, as well as functional links between the biologic template of the animal model and ability of pharmacotherapeutics to modulate or reverse biologic and behavioral modalities toward normality. Another such animal model, featuring knockout of trace amine-associated receptor 1 (TAAR1), demonstrates D2RSS with an increase in the proportion of D2R in the high-affinity state. Currently, TAAR1 agonists are being explored as a therapeutic option for schizophrenia. There is likewise an overlay of D2RSS with substance use disorder. The aspect of adenosine A2A-D2 heteroreceptor complexes in substance use disorder is highlighted, and the association of adenosine A2A receptor antagonists in discriminative and rewarding effects of psychostimulants is outlined. In summary, these new animal models of schizophrenia have face, construct, and predictive validity, and distinct advantages over earlier models. While the review summarizes elements of D2RSS in schizophrenia per se, and its interplay with substance use disorder, a major focus is on presumed new molecular targets attending D2RSS in schizophrenia and related clinical entities.
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Affiliation(s)
- Richard M Kostrzewa
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Karolina Wydra
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Malgorzata Filip
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Cynthia A Crawford
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Sanders A McDougall
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Russell W Brown
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Dasiel O Borroto-Escuela
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Kjell Fuxe
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Raul R Gainetdinov
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
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Reeves LE, Gaudiano BA, Metrik J, Guzman Holst C, Morena A, Sydnor VJ, Weinstock LM, Epstein-Lubow G. Comorbid Cannabis and Tobacco Use Disorders in Hospitalized Patients with Psychotic-Spectrum Disorders. J Dual Diagn 2018; 14:171-180. [PMID: 30265850 DOI: 10.1080/15504263.2018.1470359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Individuals with psychotic-spectrum disorders use tobacco and cannabis at higher rates than the general population and individuals with other psychiatric disorders, which may contribute to increased rates of medical problems and mortality. The present study examined whether individuals with psychosis and comorbid tobacco and/or cannabis use disorders exhibit differing clinical characteristics in terms of their sociodemographic, mental health, substance use, physical health, and medication use patterns. Elucidation of these profiles, and determining their relative severity, has important implications for treatment, including offering more targeted interventions based on type of comorbidity pattern. METHODS We examined the electronic medical records of 829 patients with psychotic-spectrum disorders admitted to a psychiatric hospital and categorized them as having: (1) cannabis use disorder (CUD); (2) tobacco use disorder (TUD); (3) comorbid cannabis and tobacco use disorders (CUD + TUD); or (4) neither disorder (no CUD/TUD). Multinomial logistic regression was used to compare the aforementioned groups on multiple variables controlling for age and sex. RESULTS Alcohol and stimulant use disorder diagnoses were each related to higher odds of having a CUD and CUD + TUD, relative to no CUD/TUD. Stimulant and polysubstance use disorder diagnoses were each related to higher odds of having a TUD compared to no CUD/TUD. Greater number of prescribed psychotropic medications was related to higher odds of a TUD compared to no CUD/TUD. CONCLUSIONS Although several differences between groups were accounted for by age of cannabis versus tobacco users, findings point to the importance of considering comorbid alcohol and substance use disorders among those with psychosis and CUD/TUD, as these comorbidities have important implications for screening and treatment selection during and following acute hospitalization.
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Affiliation(s)
- Lauren E Reeves
- a Butler Hospital, Psychosocial Research Program, Providence , Rhode Island , USA.,b Warren Alpert Medical School of Brown University , Department of Psychiatry and Human Behavior , Providence , Rhode Island , USA
| | - Brandon A Gaudiano
- a Butler Hospital, Psychosocial Research Program, Providence , Rhode Island , USA.,b Warren Alpert Medical School of Brown University , Department of Psychiatry and Human Behavior , Providence , Rhode Island , USA
| | - Jane Metrik
- c Providence Veterans Administration Medical Center , Providence , Rhode Island , USA.,d Center for Alcohol and Addiction Studies , Brown University, School of Public Health , Providence , Rhode Island , USA
| | - Carolina Guzman Holst
- a Butler Hospital, Psychosocial Research Program, Providence , Rhode Island , USA.,b Warren Alpert Medical School of Brown University , Department of Psychiatry and Human Behavior , Providence , Rhode Island , USA
| | - Alexandra Morena
- a Butler Hospital, Psychosocial Research Program, Providence , Rhode Island , USA
| | - Valerie J Sydnor
- a Butler Hospital, Psychosocial Research Program, Providence , Rhode Island , USA.,b Warren Alpert Medical School of Brown University , Department of Psychiatry and Human Behavior , Providence , Rhode Island , USA
| | - Lauren M Weinstock
- a Butler Hospital, Psychosocial Research Program, Providence , Rhode Island , USA.,b Warren Alpert Medical School of Brown University , Department of Psychiatry and Human Behavior , Providence , Rhode Island , USA
| | - Gary Epstein-Lubow
- a Butler Hospital, Psychosocial Research Program, Providence , Rhode Island , USA.,b Warren Alpert Medical School of Brown University , Department of Psychiatry and Human Behavior , Providence , Rhode Island , USA
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Al Risi K, Al Maqbali M, Asiri WA, Al Sinawi H. Rate of Tobacco Smoking Among Psychiatric Outpatients Attending a Tertiary Care Hospital in Oman:
A Cross-sectional Study. Oman Med J 2018; 33:224-228. [PMID: 29896330 DOI: 10.5001/omj.2018.41] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objectives Tobacco smoking is the single most avoidable cause of morbidity and mortality around the world. Patients with psychiatric disorders tend to smoke tobacco at a higher rate than the general population, with significant adverse health consequences. This study aimed to determine the rate of tobacco smoking among psychiatric outpatients attending Sultan Qaboos University Hospital, a tertiary care hospital in Muscat, Oman. Methods We conducted a cross-sectional study among psychiatric outpatients attending a psychiatric clinic from 1 January to 1 August 2017. The patients' demographic information, history of smoking, previous hospitalizations, and the number of and specific psychotropics used during treatment was documented. The degree of dependence on tobacco smoking was measured using the Fagerstrom test for nicotine dependence. Results A total of 272 patients were included in this study. The overall rate of smoking among psychiatric patients was 13.6%. Patients with schizophrenia had the highest rate of smoking (22.2%), followed by those with bipolar (13.1%), and anxiety disorders (11.1%). Patients who smoked tobacco were more likely to be admitted to the psychiatric ward than non-smokers (p < 0.050). Conclusions Tobacco smoking is common among psychiatric patients, a finding consistent with similar studies conducted in different parts of the world. Assessment of smoking status and its associated adverse health associations among patients with mental disorders is of paramount importance.
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Affiliation(s)
- Khalid Al Risi
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | | | | | - Hamed Al Sinawi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
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Alosaimi FD, Abalhassan M, Alhaddad B, Fallata EO, Alhabbad A, Alshenqiti R, Alassiry MZ. Gender differences and risk factors for smoking among patients with various psychiatric disorders in Saudi Arabia: a cross-sectional study. Int J Ment Health Syst 2018; 12:21. [PMID: 29755581 PMCID: PMC5934876 DOI: 10.1186/s13033-018-0201-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 04/16/2018] [Indexed: 01/06/2023] Open
Abstract
Background The higher prevalence of smoking among psychiatric patients is well established. However, gender-specific associations have rarely been the focus of studies among patients with various psychiatric disorders. The aim of this study was to estimate the gender-specific prevalence of current smoking by psychiatric patients and its association with various psychiatric disorders and the use of psychotropic medications. Methods A cross-sectional observational study was performed between July 2012 and June 2014. Patients were recruited from six hospitals located in the five regions of Saudi Arabia. Results Of the 1193 patients, 402 (33.7%) were current smokers. The incidence of current smoking was much higher among males than females (58.3% versus 6.7%, p < 0.001). In one or both genders, current smoking was associated with marital status, education, family income, residence, obesity, physical activity, substance abuse, inpatient status, previous psychiatric hospitalization, and age at onset of psychiatric illness. In both gender, smoking was higher in patients who had a secondary psychiatric disorder (66.7% versus 37.5%, respectively), those who had a primary psychotic disorder (63.7% versus 12.3%), and those taking antipsychotic medication (64.1% versus 8.3%) but lower in patients who had a primary depressive disorder (40.3% versus 4.3%), those who had a primary anxiety disorder (45.8% versus 0.0%), and those taking antidepressant medications (53.7% versus 3.6%). In a multivariate analysis adjusted for demographic/clinical characteristics and psychiatric disorders, current smoking was independently associated with primary psychotic disorders in females (OR = 3.47, 1.45–8.27, p = 0.005) but not in males. In a multivariate analysis adjusted for demographic/clinical characteristics and psychotropic medications, current smoking was independently associated with antipsychotic medication use in males (OR = 1.79, 1.10–2.93, p = 0.020). Current smoking was strongly associated with substance abuse in both univariate and multivariate analyses. Conclusion The prevalence of current smoking is high with marked gender difference in a large sample of mixed psychiatric patients in Saudi Arabia. Smoking-cessation programs may be urgently needed for these vulnerable patients.
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Affiliation(s)
- Fahad D Alosaimi
- 1Department of Psychiatry, King Saud University, # 55, King Khalid University Hospital, P.O. Box 7805, Riyadh, 11472 Saudi Arabia
| | - Mohammed Abalhassan
- 2Department of Medicine, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Bandar Alhaddad
- Department of neurosciences, Al-Imam Mohammad Bin Saud University, Riyadh, Saudi Arabia
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Lyu X, Du J, Zhan G, Wu Y, Su H, Zhu Y, Jarskog F, Zhao M, Fan X. Naltrexone and Bupropion Combination Treatment for Smoking Cessation and Weight Loss in Patients With Schizophrenia. Front Pharmacol 2018; 9:181. [PMID: 29563871 PMCID: PMC5850123 DOI: 10.3389/fphar.2018.00181] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 02/19/2018] [Indexed: 11/29/2022] Open
Abstract
Objective: The rates of obesity and cigarette smoking are much higher in patients with schizophrenia compared to the general population. This study was to examine whether naltrexone and bupropion combination treatment can help weight loss and smoking cessation in patients with schizophrenia. Methods: Obese male schizophrenia patients with current cigarette smoking were randomized to receive adjunctive naltrexone (25 mg/day) and bupropion (300 mg/day) combination or placebo for 24 weeks. Twenty-two patients were enrolled in the study, and 21 patients completed the study (11 in the treatment group, and 10 in the placebo group). Body weight, body mass index (BMI), fasting lipids, smoking urge, expired carbon monoxide (CO) level and cigarettes smoked per week were measured at baseline and week 24. Results: There was no significant difference between two groups in changes in weight, BMI, fasting lipids, or cigarette smoking measures (p's > 0.05) Conclusion: Naltrexone and bupropion combination treatment didn't show weight loss or smoking cessation effect in patients with schizophrenia in this pilot study.Implications for future studies were discussed. ClinicalTrials.gov identifier: NCT02736474.
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Affiliation(s)
- Xuechan Lyu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiang Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guilai Zhan
- Shanghai Xuhui District Mental Health Center, Shanghai, China
| | - Yujie Wu
- Shanghai Xuhui District Mental Health Center, Shanghai, China
| | - Hang Su
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Youwei Zhu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fredrik Jarskog
- North Carolina Psychiatric Research Center, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Xiaoduo Fan
- Psychotic Disorders Program, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, United States
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Kamp D, Engelke C, Wobrock T, Kunze B, Wölwer W, Winterer G, Schmidt-Kraepelin C, Gaebel W, Langguth B, Landgrebe M, Eichhammer P, Frank E, Hajak G, Ohmann C, Verde PE, Rietschel M, Raees A, Honer WG, Malchow B, Schneider-Axmann T, Falkai P, Hasan A, Cordes J. Letter to the Editor: Influence of rTMS on smoking in patients with schizophrenia. Schizophr Res 2018; 192:481-484. [PMID: 28578924 DOI: 10.1016/j.schres.2017.05.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 05/26/2017] [Accepted: 05/27/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Daniel Kamp
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
| | - Christina Engelke
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
| | - Thomas Wobrock
- Department of Psychiatry and Psychotherapy, Georg-August-University Göttingen, Göttingen, Germany; Department of Psychiatry and Psychotherapy, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany.
| | - Birgit Kunze
- Department of Psychiatry and Psychotherapy, Georg-August-University Göttingen, Göttingen, Germany.
| | - Wolfgang Wölwer
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
| | - Georg Winterer
- Experimental and Clinical Research Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Christian Schmidt-Kraepelin
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
| | - Michael Landgrebe
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany; Department of Psychiatry, Psychosomatics and Psychotherapy, kbo-Lech-Mangfall-Klinik Agatharied, Agatharied, Germany.
| | - Peter Eichhammer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
| | - Elmar Frank
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
| | - Göran Hajak
- Department of Psychiatry, Psychosomatics and Psychotherapy, Sozialstiftung Bamberg, Bamberg, Germany.
| | | | - Pablo E Verde
- Coordination Centre for Clinical Trials, Heinrich-Heine University, Düsseldorf, Germany.
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Institute of Central Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.
| | - Ahmed Raees
- Department of Medicine, University Göttingen, Referat Klinische Studien Management, Göttingen, Germany.
| | - William G Honer
- Department of Genetic Epidemiology in Psychiatry, Institute of Mental Health, The University of British Columbia, Vancouver, BC, Canada.
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
| | | | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
| | - Joachim Cordes
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
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Spagna A, He G, Jin S, Gao L, Mackie MA, Tian Y, Wang K, Fan J. Deficit of supramodal executive control of attention in schizophrenia. J Psychiatr Res 2018; 97:22-29. [PMID: 29172174 DOI: 10.1016/j.jpsychires.2017.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/21/2017] [Accepted: 11/02/2017] [Indexed: 01/30/2023]
Abstract
Although a deficit in executive control of attention is one of the hallmarks in schizophrenia that has significant impact on everyday functioning due to its relationship with thought processing, whether this deficit occurs across modalities, i.e., is supramodal, remains unclear. To investigate the supramodal mechanism in SZ, we examined cross-modal correlations between visual and auditory executive control of attention in a group of patients with schizophrenia (SZ, n = 55) compared to neurotypical controls (NC, n = 55). While the executive control effects were significantly correlated between the two modalities in the NC group, these effects were not correlated in the SZ group, with a significant group difference in the correlation. Further, the inconsistency and magnitude of the cross-modal executive control effects were significantly larger in the SZ group compared to the NC group. Together, these results suggest that there is a disruption of a common supramodal executive control mechanism in patients with schizophrenia, which may be related to the thought processing disorder characterizing the disorder.
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Affiliation(s)
- Alfredo Spagna
- Department of Psychology, Queens College, The City University of New York, Queens, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Genxia He
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Department of Neurology, The Second Hospital of Anhui Province, Hefei, Anhui Province, China
| | - Shengchun Jin
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Liling Gao
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Melissa-Ann Mackie
- Department of Psychology, Queens College, The City University of New York, Queens, NY, USA
| | - Yanghua Tian
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China.
| | - Kai Wang
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China.
| | - Jin Fan
- Department of Psychology, Queens College, The City University of New York, Queens, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Cognitive Control, the Anterior Cingulate, and Nicotinic Receptors: A Case of Heterozygote Advantage. J Neurosci 2018; 38:257-259. [PMID: 29321144 DOI: 10.1523/jneurosci.2775-17.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/06/2017] [Accepted: 11/09/2017] [Indexed: 11/21/2022] Open
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Stramecki F, Kotowicz KD, Piotrowski P, Frydecka D, Rymaszewska J, Beszłej JA, Samochowiec J, Jabłoński M, Wroński M, Moustafa AA, Misiak B. Assessment of the Association Between Cigarette Smoking and Cognitive Performance in Patients With Schizophrenia-Spectrum Disorders: A Case-Control Study. Front Psychiatry 2018; 9:642. [PMID: 30559684 PMCID: PMC6287108 DOI: 10.3389/fpsyt.2018.00642] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/15/2018] [Indexed: 12/21/2022] Open
Abstract
The prevalence of cigarette smoking is significantly higher in patients with schizophrenia compared to the general population. Schizophrenia is also characterized by cognitive impairments that can be detected in the premorbid phase of illness. However, studies addressing the association between cigarette smoking and cognition in patients with psychosis have provided mixed findings. Therefore, the aim of this study was to assess the relationship between tobacco smoking and cognitive performance in patients with schizophrenia. In this case-control study, we recruited 67 inpatients with schizophrenia (34 cigarette smokers) and 62 healthy controls (30 cigarette smokers) at two clinical sites (Wroclaw and Szczecin, Poland). Cognitive performance was examined using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Smoking dependence was determined using the Fagerström Test for Nicotine Dependence (FTND) and the pack-year index. Results show that, after adjustment for potential confounders, smokers with schizophrenia presented significantly lower scores on delayed memory tests compared to non-smokers with schizophrenia (F = 11.07, p = 0.002). In healthy controls, after adjustment for age, sex, and education level, smokers had significantly lower scores in immediate memory (47.1 ± 6.4 vs. 52.0 ± 4.0, F = 11.64, p = 0.001), visuospatial/constructional functions (34.8 ± 3.8 vs. 37.7 ± 1.8, F = 12.86, p = 0.001) and global cognition (177.0 ± 15.7 vs. 191.2 ± 14.0, F = 12.63, p = 0.001) compared to non-smokers. There were no significant correlations between FTND scores or pack-year index and cognitive performance neither in patient nor control group. Our results show that cigarette smoking is related to worse delayed memory performance in schizophrenia patients as well as deficits of immediate memory, visuospatial/constructional functions, and global cognition in controls. Longitudinal studies are required to establish causal interference between smoking and cognition in patients with schizophrenia.
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Affiliation(s)
- Filip Stramecki
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Kamila D Kotowicz
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Patryk Piotrowski
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | | | | | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Marcin Jabłoński
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Michał Wroński
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Marcs Institute of Brain and Behaviour, Western Sydney University, Penrith, NSW, Australia.,Department of Social Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Błazej Misiak
- Department of Genetics, Wroclaw Medical University, Wroclaw, Poland
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