Garcia-Portilla Maria Paz, Garcia-Alvarez Leticia, Saiz Pilar Alejandra, Diaz-Mesa Eva, Galvan Gonzalo, Sarramea Fernando, Garcia-Blanco Josefa, Elizagarate Edorta, Bobes Julio
Departmento de Psiquiatría, Universidad de Oviedo, 33006 Oviedo, Spain.
Int J Environ Res Public Health. 2013 Dec 24;11(1):373-89. doi: 10.3390/ijerph110100373.
Only a few studies have examined the efficacy and safety of smoking cessation programmes in patients with mental disorders. The aim of this paper is to describe in detail the methodology used in the study as well as the Multi-component Smoking Cessation Support Programme in terms of pharmacological treatments and psychological interventions. An open-label 9-month follow-up study was conducted in Spain. A total of 82 clinically stable outpatients with schizophrenia, schizoaffective or bipolar disorder were enrolled. Treatment consisted of a programme specifically developed by the research team for individuals with severe mental disorders. The programme consisted of two phases: (1) weekly individual motivational therapy for 4-12 weeks, and (2) a 12-week active treatment phase. During this phase, at each study visit patients received a one- or two-week supply of medication (transdermal nicotine patches, varenicline or bupropion) with instructions on how to take it, in addition to group psychotherapy for smoking cessation. Evaluations were performed: (1) at the time of enrollment in the study, (2) during the 12-week active treatment phase of the study (weekly for the first 4 weeks and then biweekly), and (3) after the end of this phase (two follow-up assessments at weeks 12 and 24). Evaluations included: (1) smoking history, (2) substance use, (3) psychopathology, (4) adverse events, and (5) laboratory tests. The importance of this study lies in addressing a topical issue often ignored by psychiatrists: the unacceptably high rates of tobacco use in patients with severe mental disorders.
仅有少数研究考察了戒烟项目在精神障碍患者中的疗效和安全性。本文旨在详细描述该研究中所使用的方法,以及多成分戒烟支持项目在药物治疗和心理干预方面的情况。在西班牙进行了一项开放标签的为期9个月的随访研究。共招募了82名患有精神分裂症、分裂情感性障碍或双相情感障碍且病情临床稳定的门诊患者。治疗由研究团队专门为重度精神障碍患者制定的项目组成。该项目包括两个阶段:(1)为期4至12周的每周一次的个体动机治疗,以及(2)为期12周的积极治疗阶段。在此阶段,在每次研究访视时,除了接受戒烟团体心理治疗外,患者还会收到为期一至两周的药物供应(经皮尼古丁贴片、伐尼克兰或安非他酮)以及用药说明。评估在以下时间点进行:(1)研究入组时,(2)研究的12周积极治疗阶段(前4周每周进行一次评估,之后每两周进行一次评估),以及(3)该阶段结束后(在第12周和第24周进行两次随访评估)。评估内容包括:(1)吸烟史,(2)物质使用情况,(3)精神病理学,(4)不良事件,以及(5)实验室检查。这项研究的重要性在于解决了一个常常被精神科医生忽视的热门问题:重度精神障碍患者中烟草使用率高得令人无法接受。