抗精神病药物与门诊精神分裂症患者的烟草使用：一项横断面研究。
Antipsychotic medication and tobacco use among outpatients with schizophrenia: a cross-sectional study.
机构信息
University Psychiatry Unit, National Hospital of Sri Lanka, Colombo 08, Sri Lanka.
Department of Psychological Medicine, Faculty of Medicine, University of Colombo, Kynsey Road, Colombo 08, Sri Lanka.
出版信息
Ann Gen Psychiatry. 2014 Mar 19;13(1):7. doi: 10.1186/1744-859X-13-7.
BACKGROUND
Many studies have shown that the prevalence of smoking in schizophrenia is higher than in the general population. Biological, psychological and social factors influence smoking in patients with schizophrenia.
METHODS
The study was carried out in psychiatry outpatient clinics in a tertiary care hospital in Sri Lanka. Every third patient was selected using systematic sampling from patients diagnosed with schizophrenia according to ICD-10 clinical criteria. Smoking behaviours were assessed using self-reports. Severity of illness was assessed using Brief Psychiatric Rating Scale (BPRS). Fagerstrom Test for Nicotine Dependence assessed level of dependence. Readiness to Change Questionnaire assessed motivation to change smoking behaviour.
RESULTS
The sample consisted of 306 patients with schizophrenia. Mean age was 38.93 years (SD 10.98). There were 148 males (48.4%). Mean duration of illness was 12.63 years (SD 8.38). Current medication was oral atypical antipsychotics 103, clozapine 136, oral typicals 29 and depot typicals 38. Prevalence of tobacco use among males was 30.41% (95% CI 22.91 to 37.90) and among females 1.90% (95% CI -0.25 to 4.05). Prevalence of current smoking among males was 20.27% (95% CI 13.72 to 26.82). None of the females smoked. Prevalence of smokeless tobacco use among males was 10.14 (95% CI 5.22 to 15.05) and among females 1.90 (95% CI -0.03 to 4.05). When patients treated with clozapine were excluded from the analysis, prevalence of tobacco use was 41.6% among males and 3.2% among females and prevalence of smoking was 29.9% among males. Prevalence of tobacco use was lowest in patients treated with clozapine 18.31 (95% CI 9.09 to 27.53) and highest in those treated with depot antipsychotics 47.83 (95% CI 25.74 to 69.91).
CONCLUSIONS
Prevalence of smoking was less than in many countries. This is influenced by prevalence in the general population and low affordability. Risk of tobacco use was significantly less among patients treated with clozapine.
背景
许多研究表明，精神分裂症患者的吸烟率高于一般人群。生物、心理和社会因素影响着精神分裂症患者的吸烟行为。
方法
该研究在斯里兰卡一家三级保健医院的精神病门诊进行。根据 ICD-10 临床标准，从精神分裂症患者中采用系统抽样方法，每 3 名患者中就有 1 名被选入研究。使用自我报告评估吸烟行为。采用简明精神病评定量表（BPRS）评估疾病严重程度。尼古丁依赖程度评估采用 Fagerstrom 测试。改变吸烟行为的意愿评估采用改变意愿问卷。
结果
样本包括 306 名精神分裂症患者。平均年龄为 38.93 岁（SD 10.98）。男性 148 例（48.4%）。平均病程为 12.63 年（SD 8.38）。目前的药物治疗为口服非典型抗精神病药 103 例，氯氮平 136 例，口服典型抗精神病药 29 例，长效典型抗精神病药 38 例。男性烟草使用率为 30.41%（95%CI 22.91-37.90），女性为 1.90%（95%CI -0.25-4.05）。男性目前吸烟率为 20.27%（95%CI 13.72-26.82）。没有女性吸烟。男性使用无烟烟草的比例为 10.14%（95%CI 5.22-15.05），女性为 1.90%（95%CI -0.03-4.05）。在排除氯氮平治疗患者的分析中，男性烟草使用率为 41.6%，女性为 3.2%，男性吸烟率为 29.9%。氯氮平治疗患者的烟草使用率最低，为 18.31%（95%CI 9.09-27.53），长效抗精神病药治疗患者的使用率最高，为 47.83%（95%CI 25.74-69.91）。
结论
吸烟率低于许多国家。这是受一般人群的流行率和较低的可负担性的影响。氯氮平治疗患者的烟草使用风险显著降低。
Zotero 插件