Stramecki Filip, Kotowicz Kamila D, Piotrowski Patryk, Frydecka Dorota, Rymaszewska Joanna, Beszłej Jan Aleksander, Samochowiec Jerzy, Jabłoński Marcin, Wroński Michał, Moustafa Ahmed A, Misiak Błazej
Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland.
Front Psychiatry. 2018 Dec 3;9:642. doi: 10.3389/fpsyt.2018.00642. eCollection 2018.
The prevalence of cigarette smoking is significantly higher in patients with schizophrenia compared to the general population. Schizophrenia is also characterized by cognitive impairments that can be detected in the premorbid phase of illness. However, studies addressing the association between cigarette smoking and cognition in patients with psychosis have provided mixed findings. Therefore, the aim of this study was to assess the relationship between tobacco smoking and cognitive performance in patients with schizophrenia. In this case-control study, we recruited 67 inpatients with schizophrenia (34 cigarette smokers) and 62 healthy controls (30 cigarette smokers) at two clinical sites (Wroclaw and Szczecin, Poland). Cognitive performance was examined using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Smoking dependence was determined using the Fagerström Test for Nicotine Dependence (FTND) and the pack-year index. Results show that, after adjustment for potential confounders, smokers with schizophrenia presented significantly lower scores on delayed memory tests compared to non-smokers with schizophrenia ( = 11.07, = 0.002). In healthy controls, after adjustment for age, sex, and education level, smokers had significantly lower scores in immediate memory (47.1 ± 6.4 vs. 52.0 ± 4.0, = 11.64, = 0.001), visuospatial/constructional functions (34.8 ± 3.8 vs. 37.7 ± 1.8, = 12.86, = 0.001) and global cognition (177.0 ± 15.7 vs. 191.2 ± 14.0, = 12.63, = 0.001) compared to non-smokers. There were no significant correlations between FTND scores or pack-year index and cognitive performance neither in patient nor control group. Our results show that cigarette smoking is related to worse delayed memory performance in schizophrenia patients as well as deficits of immediate memory, visuospatial/constructional functions, and global cognition in controls. Longitudinal studies are required to establish causal interference between smoking and cognition in patients with schizophrenia.
与普通人群相比，精神分裂症患者中吸烟的流行率显著更高。精神分裂症的特征还包括在疾病的病前阶段就可检测到的认知障碍。然而，针对精神病患者吸烟与认知之间关联的研究结果不一。因此，本研究的目的是评估精神分裂症患者吸烟与认知表现之间的关系。在这项病例对照研究中，我们在两个临床地点（波兰弗罗茨瓦夫和什切青）招募了67名精神分裂症住院患者（34名吸烟者）和62名健康对照者（30名吸烟者）。使用可重复神经心理状态评估量表（RBANS）检查认知表现。使用尼古丁依赖的Fagerström测试（FTND）和包年指数确定吸烟依赖性。结果显示，在对潜在混杂因素进行调整后，与不吸烟的精神分裂症患者相比，吸烟的精神分裂症患者在延迟记忆测试中的得分显著更低（= 11.07，= 0.002）。在健康对照者中，在对年龄、性别和教育水平进行调整后，吸烟者在即时记忆（47.1 ± 6.4 vs. 52.0 ± 4.0，= 11.64，= 0.001）、视觉空间/构建功能（34.8 ± 3.8 vs. 37.7 ± 1.8，= 12.86，= 0.001）和整体认知（177.0 ± 15.7 vs. 191.2 ± 14.0，= 12.63，= 0.001）方面的得分显著低于不吸烟者。在患者组和对照组中，FTND得分或包年指数与认知表现之间均无显著相关性。我们的结果表明，吸烟与精神分裂症患者较差的延迟记忆表现以及对照组的即时记忆、视觉空间/构建功能和整体认知缺陷有关。需要进行纵向研究以确定精神分裂症患者吸烟与认知之间的因果关系。
