Apud J A, Egan M F, Wyatt R J
Neuroscience Center at St. Elizabeth's, Neuropsychiatry Branch, National Institute of Mental Health, 2700 Martin Luther King, Jr. Ave., SE, Washington, DC 20032, USA.
Schizophr Res. 2000 Dec 15;46(2-3):119-27. doi: 10.1016/s0920-9964(99)00230-3.
A number of studies have shown that patients with schizophrenia smoke more than other psychiatric patients and more than the general population. Also, medicated schizophrenics who smoke present more positive symptoms of schizophrenia than non-smokers. The objective of the present study was to assess the effect of smoking on ratings of psychopathology for 30 days following discontinuation of antipsychotic medication. The subjects were 101 treatment-resistant patients with schizophrenia who had been admitted to the inpatient service of Neuroscience Research Hospital (NRH), National Institute of Mental Health, between 1982 and 1994 to undergo studies involving discontinuation of antipsychotic medication. Patients were rated independently on a daily basis on the 22-item Psychiatric Symptom Assessment Scale (PSAS), an extended version of the Brief Psychiatric Rating Scale (BPRS). At baseline, ratings for Verbal Positive, Paranoia and Loss of Function were higher in smokers (n=65) than non-smokers (n=36), but a statistically significant difference was observed only for the Verbal Positive cluster. Analysis by gender revealed that male non-smokers had the lowest psychopathology ratings at baseline. There were no differences in Anxiety/depression, Behavior Positive, Deficit Symptoms or Mannerisms (a measure for abnormal involuntary movements). Following medication discontinuation, repeated-measure analysis demonstrated a 'time' effect for all the variables studied and a 'group' (smokers vs. non-smokers) effect for Verbal Positive, Paranoia, and Loss of Function. Post-hoc comparisons at individual time points showed significantly higher ratings for smokers at week 1 for Paranoia. No differences were observed at later time points. In conclusion, at baseline, smokers had more positive symptoms and were apparently more functionally impaired than non-smokers. This difference was no longer evident after a 30 day medication discontinuation period.
多项研究表明，精神分裂症患者比其他精神科患者吸烟更多，也比普通人群吸烟更多。此外，吸烟的精神分裂症患者比不吸烟者表现出更多的精神分裂症阳性症状。本研究的目的是评估在停用抗精神病药物后30天内吸烟对精神病理学评分的影响。研究对象为101名难治性精神分裂症患者，他们于1982年至1994年间入住国立精神卫生研究所神经科学研究医院（NRH）的住院部，接受涉及停用抗精神病药物的研究。患者每天独立接受22项精神症状评估量表（PSAS）的评分，该量表是简明精神病评定量表（BPRS）的扩展版本。在基线时，吸烟者（n = 65）的言语阳性、偏执和功能丧失评分高于不吸烟者（n = 36），但仅在言语阳性聚类中观察到统计学上的显著差异。按性别分析显示，男性不吸烟者在基线时的精神病理学评分最低。在焦虑/抑郁、行为阳性、缺陷症状或怪癖（异常不自主运动的指标）方面没有差异。停用药物后，重复测量分析显示，所有研究变量都有“时间”效应，言语阳性、偏执和功能丧失有“组”（吸烟者与不吸烟者）效应。在各个时间点的事后比较显示，吸烟者在第1周的偏执评分显著更高。在后续时间点未观察到差异。总之，在基线时，吸烟者比不吸烟者有更多的阳性症状，且功能明显受损。在停用药物30天后，这种差异不再明显。
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