Barr Alasdair M, Procyshyn Ric M, Hui Philip, Johnson Joy L, Honer William G
Faculty of Medicine, Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada.
Schizophr Res. 2008 Mar;100(1-3):252-60. doi: 10.1016/j.schres.2007.11.027. Epub 2008 Jan 4.
The prevalence of smoking in schizophrenia has reliably been reported as being higher than for any other psychiatric disorder. While a number of theories have been proposed to account for such high rates of smoking, little is known about the subjective motivation for why schizophrenia patients smoke in comparison with those without the disease.
The aim of the present study was to evaluate and compare smoking motivation in control subjects and schizophrenia patients, and determine if factors such as type of medication or access to cigarettes could contribute to self-reported motivation for smoking.
We assessed motivation to smoke in 61 schizophrenia inpatients and 33 non-psychiatric health worker controls at a tertiary care psychiatric facility in a cross-sectional study. Nicotine dependency and smoking behavior were evaluated using the Fagerstrom Test for Nicotine Dependence and a validated questionnaire that assesses motivation for smoking along seven different dimensions.
Schizophrenia patients reported a stronger motivation to smoke than controls for reasons related to pleasure from the act of smoking, as well as a need for psychomotor stimulation. Scores on both these factors were significantly associated with daily antipsychotic drug dose. The sedative and anxiolytic effects of smoking were related to anticholinergic load of psychiatric medications.
The findings highlight important differences in self-reported motivation to smoke between schizophrenia patients and normals. Antipsychotic drugs may also influence aspects of motivation to smoke.
据可靠报道，精神分裂症患者的吸烟率高于任何其他精神疾病。虽然已经提出了许多理论来解释如此高的吸烟率，但与非精神分裂症患者相比，对于精神分裂症患者吸烟的主观动机知之甚少。
本研究的目的是评估和比较对照组和精神分裂症患者的吸烟动机，并确定药物类型或获取香烟的难易程度等因素是否会影响自我报告的吸烟动机。
在一项横断面研究中，我们在一家三级护理精神病院评估了61名精神分裂症住院患者和33名非精神科医护人员对照者的吸烟动机。使用尼古丁依赖的法格斯特龙测试和一份经过验证的问卷评估尼古丁依赖和吸烟行为，该问卷从七个不同维度评估吸烟动机。
精神分裂症患者报告称，出于吸烟行为带来的愉悦以及精神运动刺激的需求，他们比对照组有更强的吸烟动机。这两个因素的得分均与每日抗精神病药物剂量显著相关。吸烟的镇静和抗焦虑作用与精神科药物的抗胆碱能负荷有关。
研究结果突出了精神分裂症患者和正常人在自我报告的吸烟动机方面的重要差异。抗精神病药物也可能影响吸烟动机的各个方面。
