Schermitzler Brandon, Miley Kathleen, Vinogradov Sophia, Ramsay Ian S
Department of Psychiatry and Behavioral Sciences, University of Minnesota, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
School of Nursing, University of Minnesota, 308 SE Harvard Street, Minneapolis, MN 55454, USA.
J Clin Med. 2021 Apr 11;10(8):1619. doi: 10.3390/jcm10081619.
Smoking is highly prevalent in people with psychotic disorders, even in the earliest phases of the illness. The neural mechanisms of nicotine dependence and psychosis overlap and may also be linked to deficits in neurocognition and motivation in psychosis. Both neurocognition and motivation are recognized as important clinical targets, though previous research examining the effects of smoking on these features has been inconsistent. Here, we examine the relationships between smoking status and neurocognition and motivation over the first two years of treatment for psychosis through a secondary analysis of the Recovery After an Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP) dataset. In a sample of 404 individuals with first-episode psychosis, we examined linear mixed-effects models with the group (smoker vs. non-smoker) by time (baseline, 12-month, 24-month) interaction as a predictor of global cognition and motivation. While all individuals showed enhanced global cognition and motivation over the 24-month course of treatment, non-smokers showed significantly greater gains in motivation. These changes in motivation also corresponded to improvements in functioning over the 24-month period. No significant effects of smoking were observed for global cognition. Our findings suggest that motivation and smoking cessation may be important early treatment targets for first-episode psychosis programs.
吸烟在患有精神疾病的人群中非常普遍，即使在疾病的早期阶段也是如此。尼古丁依赖和精神病的神经机制相互重叠，也可能与精神病患者的神经认知和动机缺陷有关。神经认知和动机都被认为是重要的临床靶点，尽管先前研究吸烟对这些特征的影响结果并不一致。在此，我们通过对首次精神分裂症发作后早期治疗项目（RAISE-ETP）数据集的二次分析，研究了精神病治疗头两年内吸烟状况与神经认知和动机之间的关系。在一个由404名首发精神病患者组成的样本中，我们检验了线性混合效应模型，将组（吸烟者与非吸烟者）与时间（基线、12个月、24个月）的交互作用作为整体认知和动机的预测指标。虽然所有个体在24个月的治疗过程中整体认知和动机都有所增强，但非吸烟者在动机方面的改善更为显著。这些动机的变化也与24个月期间功能的改善相对应。未观察到吸烟对整体认知有显著影响。我们的研究结果表明，动机和戒烟可能是首发精神病治疗项目重要的早期治疗靶点。
