Barnes Mark, Lawford Bruce R, Burton Simon C, Heslop Karen R, Noble Ernest P, Hausdorf Karrin, Young Ross McD
Division of Mental Health, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Aust N Z J Psychiatry. 2006 Jun-Jul;40(6-7):575-80. doi: 10.1080/j.1440-1614.2006.01841.x.
Smoking rate is disproportionately high among patients with schizophrenia, resulting in significant morbidity and mortality. However, cigarette smoking has been reported to have beneficial effects on negative symptoms, extrapyramidal symptoms, cognitive functioning and mood symptoms. Therefore, smoking cessation may worsen disability in schizophrenia. The association between smoking and these key clinical parameters was examined. Additionally, severity of smoking across four different antipsychotic treatment groups was explored.
One hundred and forty-six patients with schizophrenia were assessed for smoking using expired carbon monoxide and smoking history. They were administered the Positive and Negative Symptom Scale, The Extrapyramidal Symptom Rating Scale, the Barnes Akathisia Rating Scale, Reitans Trail-making Test (A and B) and General Health Questionnaire-28.
There was no difference in the chlorpromazine equivalent dose of any of the medications studied. Atypical agents were associated with significantly lower levels of smoking when compared with typical medications. There was no difference in smoking severity between the individual atypical medications examined. Similarly, there were no significant differences between smoking and non-smoking groups with regard to Positive and Negative Symptom Scale, Extrapyramidal Symptom Rating Scale, Trail-making Test and General Health Questionnaire-28. However, there was a significant difference between these groups with the smoking group demonstrating less akathisia.
Smoking is not associated with positive, negative cognitive and mood symptoms in schizophrenia. Smoking is associated with lower levels of antipsychotic induced akathisia. Clinicians should not be discouraged from helping patients stop smoking for fear of worsening symptoms. However, akathisia may emerge upon cessation of smoking. Switching patients from typical to atypical antipsychotics may assist patients with schizophrenia to give up smoking.
精神分裂症患者的吸烟率高得不成比例，导致了显著的发病率和死亡率。然而，据报道吸烟对阴性症状、锥体外系症状、认知功能和情绪症状有有益影响。因此，戒烟可能会加重精神分裂症患者的残疾程度。本研究考察了吸烟与这些关键临床参数之间的关联。此外，还探讨了四个不同抗精神病药物治疗组的吸烟严重程度。
对146例精神分裂症患者进行了呼出一氧化碳和吸烟史评估，以确定其吸烟情况。对患者进行了阳性与阴性症状量表、锥体外系症状评定量表、巴恩斯静坐不能评定量表、雷顿连续性能测验（A和B）以及一般健康问卷-28评估。
所研究的任何药物的氯丙嗪等效剂量均无差异。与典型药物相比，非典型药物与显著更低的吸烟水平相关。所检查的各个非典型药物之间的吸烟严重程度无差异。同样，在阳性与阴性症状量表、锥体外系症状评定量表、连续性能测验和一般健康问卷-28方面，吸烟组和非吸烟组之间无显著差异。然而，这些组之间存在显著差异，吸烟组的静坐不能症状较少。
吸烟与精神分裂症的阳性、阴性、认知和情绪症状无关。吸烟与抗精神病药物引起的较低水平的静坐不能相关。临床医生不应因担心症状恶化而不鼓励患者戒烟。然而，戒烟后可能会出现静坐不能。将患者从典型抗精神病药物换用非典型抗精神病药物可能有助于精神分裂症患者戒烟。
