Department of Neuroscience, Medical School, FMABC University Center.
Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France.
Int Rev Psychiatry. 2023 Aug-Sep;35(5-6):486-495. doi: 10.1080/09540261.2023.2252907. Epub 2023 Sep 1.
People with severe mental disorders have a higher mortality rate due to preventable conditions like cardiovascular diseases and respiratory diseases. Nicotine addiction is a preventable risk factor, with tobacco use being twice as high in people with mental disorders. An integrative model that divides mental disorders into externalising, internalising, and thought disorders could be useful for identifying common causalities and risk factors. This review aims to examine the interface between smoking and internalising disorders, specifically schizophrenia, depressive disorders, and anxiety disorders. The review finds that there is a clear association between smoking behaviour and these disorders. Schizophrenia is associated with polymorphisms that result in an imbalance between glutamate and GABA release and abnormalities of dopaminergic pathways. Nicotine improves dopaminergic signalling and balances glutamatergic and GABAergic pathways, improving symptoms and increasing the risk of nicotine dependence. In depressive disorders, smoking is associated with functional changes in brain regions affected by smoking and self-medication. In anxiety disorders, there is a bidirectional relationship with smoking, involving the amygdala and changes in dopaminergic pathways and cortisol production. Smoking poses a threat to people living with psychiatric disorders and calls for further research to assess the interactions between nicotine dependence and internalising and thought disorders.
患有严重精神障碍的人因心血管疾病和呼吸系统疾病等可预防疾病而导致死亡率较高。尼古丁成瘾是可预防的风险因素，精神障碍患者的烟草使用率是正常人的两倍。一种将精神障碍分为外显、内显和思维障碍的综合模型，可用于识别常见的因果关系和风险因素。本综述旨在研究吸烟与内隐障碍（特别是精神分裂症、抑郁障碍和焦虑障碍）之间的关系。综述发现，吸烟行为与这些障碍之间存在明显的关联。精神分裂症与导致谷氨酸和 GABA 释放失衡以及多巴胺能途径异常的多态性有关。尼古丁改善多巴胺能信号传递，并平衡谷氨酸能和 GABA 能途径，从而改善症状并增加尼古丁依赖的风险。在抑郁障碍中，吸烟与受吸烟和自我治疗影响的大脑区域的功能变化有关。在焦虑障碍中，吸烟与焦虑障碍之间存在双向关系，涉及杏仁核以及多巴胺能途径和皮质醇产生的变化。吸烟对患有精神疾病的人构成威胁，需要进一步研究来评估尼古丁依赖与内隐和思维障碍之间的相互作用。
