Faculty of Health and Life Sciences, De Montfort University, Leicester, UK; Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
Neurology Center, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; Department of Neuropsychiatry & Behavioral Neurology and Clinical Psychology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China.
Psychiatry Res. 2019 Feb;272:155-163. doi: 10.1016/j.psychres.2018.12.064. Epub 2018 Dec 10.
The "Self-medication hypothesis" that has been developed to explain the effect of nicotine in improving aspects of cognitive impairment in schizophrenia remains controversial. This systematic review and meta-analysis compared cognitive functions between smoking and non-smoking schizophrenia patients. The PubMed, PsycINFO, EMBASE, Web of Science, and Cochrane Library databases were systematically and independently searched. Basic demographic and clinical characteristics, smoking history and cognitive performance were recorded. Seven of the 11 studies included in the study, had meta-analyzable data. Compared to non-smoking schizophrenia patients, their smoking counterparts showed significant deficits on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)-immediate memory (n = 739), the RBANS-total score (n = 739) and the Continuous Performance Test-Identical Pairs (n = 157). Two of the 4 studies without meta-analysable data did not report significant group difference in performance on the Wechsler Digit Span Task and the Beck Cognitive Insight Scale, while the other 2 studies found that non-smokers outperformed than smokers in problem solving and visual learning. In conclusion, this systematic review and meta-analysis found that smoking schizophrenia patients had worse performance in certain cognitive tasks than non-smoking patients, casting doubts on the validity of the "self-medication hypothesis" that needs to be further examined.
为了解释尼古丁改善精神分裂症认知障碍方面的作用，提出了“自我用药假说”，但该假说仍存在争议。本系统评价和荟萃分析比较了吸烟和不吸烟精神分裂症患者的认知功能。系统地独立检索了 PubMed、PsycINFO、EMBASE、Web of Science 和 Cochrane Library 数据库。记录了基本的人口统计学和临床特征、吸烟史和认知表现。纳入的 11 项研究中有 7 项具有可进行荟萃分析的数据。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重复神经心理状态评估电池（RBANS）-即时记忆（n=739）、RBANS 总分（n=739）和连续性能测试-相同对（n=157）上表现出明显的缺陷。没有可进行荟萃分析的数据的 4 项研究中的 2 项报告了韦氏数字跨度任务和贝克认知洞察力量表上的表现没有显著的组间差异，而另外 2 项研究发现非吸烟者在解决问题和视觉学习方面的表现优于吸烟者。总之，本系统评价和荟萃分析发现，吸烟的精神分裂症患者在某些认知任务上的表现比不吸烟的患者差，这对“自我用药假说”的有效性提出了质疑，需要进一步研究。
