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Bennett ME, Medoff D, Cowan T, Fang L, Kacmarek C, Oikonomou MT, Calkins ME, Baker KK, Bencivengo D, Boumaiz Y, Buchanan RW, Campbell P, Chengappa KNR, Conroy CG, Cooke A, Dong F, Fauble M, Goldberg RW, Harvin A, Jumper MBE, Kauffman B, Kelly C, Kohler CG, Kreyenbuhl J, Li L, Lucksted A, Margolis RL, Marsteller JA, Moxam A, Namowicz D, Oko J, Riggs J, Saravana A, Sarpal DK, Scheinberg R, Smith WR, States R, Taylor J, Vatza C, Wolcott M, Dickerson F. Tobacco smoking and nicotine vaping in persons with first episode psychosis. Schizophr Res 2024; 267:141-149. [PMID: 38547716 PMCID: PMC11102839 DOI: 10.1016/j.schres.2024.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 05/21/2024]
Abstract
Tobacco smoking is highly prevalent in persons with psychosis and is the leading cause of preventable mortality in this population. Less is known about tobacco smoking in persons with first episode psychosis (FEP) and there have been no estimates about the prevalence of nicotine vaping in FEP. This study reports rates of tobacco smoking and nicotine vaping in young people with FEP enrolled in Coordinated Specialty Care programs in Pennsylvania and Maryland. Using data collected from 2021 to 2023, we examined lifetime and recent smoking and vaping and compared smokers and vapers to nonusers on symptoms, functioning, and substance use. The sample included 445 participants aged 13-35 with recent psychosis onset. Assessments were collected by program staff. Overall, 28 % of participants engaged in either smoking or vaping within 30 days of the admission assessment. Smokers and vapers were disproportionately male, cannabis users, and had lower negative symptom severity than non-smokers. Vapers had higher role and social functioning. Both smoking and vaping were related to a longer time from psychosis onset to program enrollment. We compare these findings to previous studies and suggest steps for addressing smoking and vaping in this vulnerable population.
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Affiliation(s)
- Melanie E Bennett
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Deborah Medoff
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Tovah Cowan
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Lijuan Fang
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Corinne Kacmarek
- VA VISN5 Mental Illness Research, Education, and Clinical Center, Baltimore, MD, USA
| | - Maria Theodora Oikonomou
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Monica E Calkins
- Pennsylvania Early Intervention Center (PEIC)/HeadsUp, Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Krista K Baker
- Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Donna Bencivengo
- Pennsylvania Early Intervention Center (PEIC)/HeadsUp, Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yasmine Boumaiz
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Phillip Campbell
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - K N Roy Chengappa
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Catherine G Conroy
- Pennsylvania Early Intervention Center (PEIC)/HeadsUp, Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Akinyi Cooke
- Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Fanghong Dong
- Pennsylvania Early Intervention Center (PEIC)/HeadsUp, Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mandy Fauble
- University of Pittsburgh Medical Center, Western Behavioral Health at Safe Harbor, Erie, PA, USA
| | - Richard W Goldberg
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Megan B E Jumper
- Pennsylvania Early Intervention Center (PEIC)/HeadsUp, Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Belinda Kauffman
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Christian G Kohler
- Pennsylvania Early Intervention Center (PEIC)/HeadsUp, Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Julie Kreyenbuhl
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Lan Li
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Alicia Lucksted
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Russell L Margolis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jill A Marsteller
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alex Moxam
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Jamie Oko
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jessie Riggs
- Pennsylvania Early Intervention Center (PEIC)/HeadsUp, Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Arunadevi Saravana
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Deepak K Sarpal
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; UPMC, Western Psychiatric Hospital, Pittsburgh, PA, USA
| | - Rachel Scheinberg
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - William R Smith
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Richard States
- University of Pittsburgh Medical Center, Western Behavioral Health at Safe Harbor, Erie, PA, USA
| | - Jerome Taylor
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Crystal Vatza
- Pennsylvania Early Intervention Center (PEIC)/HeadsUp, Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Max Wolcott
- Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Faith Dickerson
- Department of Psychology, Sheppard Pratt, Baltimore, MD, USA
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2
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Thaker P, Gartner C, Kisely S, Plever S. Systematic review of tobacco smoking prevalence among young people in treatment for first-episode psychosis. Int J Ment Health Nurs 2024. [PMID: 38606655 DOI: 10.1111/inm.13332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 02/28/2024] [Accepted: 03/27/2024] [Indexed: 04/13/2024]
Abstract
To determine whether smoking prevalence in first-episode psychosis (FEP) is different than in people with established psychosis in long-term treatment. A systematic review of cross-sectional, case-control and cohort studies identified from searches of PubMed, Embase, CINAHL and PsycINFO up to 12 August 2023. 20 studies out of 2773 screened titles were included. There was no clear pattern of smoking by diagnosis as smoking rates in people with FEP ranged from 43% to 78%, while in those with established psychosis, it ranged from 19% to 76%. The wide range of smoking levels in both populations precluded conclusions as to whether smoking rates are different between people with FEP and established psychosis suggesting that factors other than the time course of the illness influence smoking levels.
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Affiliation(s)
- Parth Thaker
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Coral Gartner
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame (Tobacco Endgame CRE), The University of Queensland, Brisbane, Queensland, Australia
| | - Steve Kisely
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Metro South Addiction and Mental Health Service, Brisbane, Queensland, Australia
| | - Sally Plever
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame (Tobacco Endgame CRE), The University of Queensland, Brisbane, Queensland, Australia
- Metro North Mental Health, Brisbane, Queensland, Australia
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3
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Viejo Casas A, Amado Diago C, Agüero Calvo J, Gómez-Revuelta M, Ruiz Núñez M, Juncal-Ruiz M, Pérez-Iglesias R, Fuentes-Pérez P, Crespo-Facorro B, Vázquez-Bourgon J. Individuals with psychosis present a reduced lung diffusion capacity and early spirometry alterations: Results from a cross-sectional study. J Psychosom Res 2024; 176:111554. [PMID: 37992571 DOI: 10.1016/j.jpsychores.2023.111554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/07/2023] [Accepted: 11/15/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVE Individuals with psychosis present a greater prevalence of chronic lung diseases, including Chronic Obstructive Pulmonary Disease (COPD). These chronic respiratory diseases are preceded by early lung function alterations; such as preserved ratio impaired spirometry (PRISm) or normal spirometry but low diffusion capacity of the lung for carbon monoxide (DLCO). However, there is no previous evidence on these lung function alterations in psychosis. The aim of this study is to evaluate the risk of having spirometry and DLCO alterations in subjects with psychosis compared with a control group. METHODS Cross-sectional study on a cohort of 170 individuals including 96 subjects with psychosis and 74 sex-age-and smoking habit matched healthy controls. All subjects were under 60 years-old, and without COPD or asthma. Respiratory function was evaluated through spirometry. Clinical characteristics and DLCO values were recorded. RESULTS Patients with psychosis showed lower spirometry results, both in terms of absolute and percentage of Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1). Absolute and percentage levels of diffusion were also lower in patients with psychosis. The percentage of individuals with DLCO<80% was higher among patients with psychosis (75% vs. 40%, p < 0.001). And the prevalence of PRISm was higher among patients with psychosis (10.4% vs. 1.4%, p < 0.001). Multivariate logistic regression analysis indicated that psychosis was an independent predictor of DLCO<80% (OR 5.67, CI95% 1.86-17.27). CONCLUSION Patients with psychosis and females had early alterations in lung function. These results suggest that early screening for lung disease should be encouraged in psychosis.
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Affiliation(s)
- Ana Viejo Casas
- Pisueña-Cayón Primary Care Centre, Sarón, Spain; Instituto de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Carlos Amado Diago
- Instituto de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), Santander, Spain; Department of Pneumology, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain.
| | - Juan Agüero Calvo
- Department of Pneumology, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain
| | - Marcos Gómez-Revuelta
- Instituto de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), Santander, Spain; Department of Psychiatry, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain
| | | | - María Juncal-Ruiz
- Instituto de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), Santander, Spain; Department of Psychiatry, Hospital Sierrallana, Universidad de Cantabria, Santander, Spain
| | - Rocío Pérez-Iglesias
- Instituto de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), Santander, Spain; Department of Psychiatry, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain
| | - Paloma Fuentes-Pérez
- Instituto de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio-IBIS, Sevilla, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Seville, Spain
| | - Javier Vázquez-Bourgon
- Instituto de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), Santander, Spain; Department of Psychiatry, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Seville, Spain.
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4
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Viejo Casas A, Amado Diago C, Agüero Calvo J, Gómez-Revuelta M, Suarez Pinilla P, Ovejas Catalán C, Fuentes Pérez P, Ruiz Núñez M, Garrastazu López R, Juncal Ruiz M, Crespo-Facorro B, Vázquez-Bourgon J. Increased risk of early lung function alterations in people with psychosis: A cross-sectional case-control study. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023:S2950-2853(23)00091-1. [PMID: 37992811 DOI: 10.1016/j.sjpmh.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/14/2023] [Accepted: 10/23/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Tobacco smoking has been described as the main cause of chronic obstructive pulmonary disease (COPD) and this habit is clearly more frequent among individuals with psychosis than in the general population, with rates reaching up to 60%. However, little attention has been focused on the association of COPD and psychosis. We aimed to explore the risk of presenting early lung function alterations in a group of individuals with psychosis. METHODS Following an observational cross-sectional design we studied a cohort of individuals with established psychosis (N=128), and compared them with a sex, age, and smoking habit matched control group (N=79). We evaluated respiratory symptoms by means of mMRC, CAT and Dyspnea-12 scales. And lung function through spirometry tests. RESULTS Individuals with psychosis presented more respiratory symptoms than controls. Similarly, we observed significant differences in the lung function tests between these two groups, where individuals with psychosis presented worse results in most of the spirometry mean values (FEV1 or forced expiratory volume in the first one second: 3.29L vs. 3.75L, p<0.001; forced vital capacity or FVC: 4.25L vs. 4.72L, p=0.002; and FEV1/FVC ratio: 0.78 vs. 0.80, p=0.052). Patients also presented worse values of lung diffusion, with lower diffusing capacity for carbon monoxide (DLCO) than controls (6.95 vs. 8.54mmol/min/kPa, p<0.001). CONCLUSIONS The individuals with psychosis in our study presented greater respiratory symptoms and poorer lung function measured through spirometry. These signs have been described as early signs of COPD.
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Affiliation(s)
- Ana Viejo Casas
- Pisueña-Cayón Primary Care Centre, Sarón, Spain; Institute of Biomedical Research Valdecilla (IDIVAL), Santander, Spain.
| | - Carlos Amado Diago
- Institute of Biomedical Research Valdecilla (IDIVAL), Santander, Spain; Department of Pneumology, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria, Santander, Spain
| | - Juan Agüero Calvo
- Department of Pneumology, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria, Santander, Spain
| | - Marcos Gómez-Revuelta
- Institute of Biomedical Research Valdecilla (IDIVAL), Santander, Spain; Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria, Santander, Spain
| | - Paula Suarez Pinilla
- Institute of Biomedical Research Valdecilla (IDIVAL), Santander, Spain; Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria, Santander, Spain
| | | | | | | | | | - María Juncal Ruiz
- Institute of Biomedical Research Valdecilla (IDIVAL), Santander, Spain; Department of Psychiatry, Sierrallana Hospital, School of Medicine (UC), Torrelavega, Spain
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocío-IBIS, Sevilla, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Sevilla, Spain
| | - Javier Vázquez-Bourgon
- Institute of Biomedical Research Valdecilla (IDIVAL), Santander, Spain; Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria, Santander, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Sevilla, Spain.
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5
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Sánchez-Gutiérrez T, Rodríguez-Toscano E, Roldán L, Ferraro L, Parellada M, Calvo A, López G, Rapado-Castro M, La Barbera D, La Cascia C, Tripoli G, Di Forti M, Murray RM, Quattrone D, Morgan C, van Os J, García-Portilla P, Al-Halabí S, Bobes J, de Haan L, Bernardo M, Santos JL, Sanjuán J, Arrojo M, Ferchiou A, Szoke A, Rutten BP, Stilo S, D'Andrea G, Tarricone I, Díaz-Caneja CM, Arango C. Tobacco use in first-episode psychosis, a multinational EU-GEI study. Psychol Med 2023; 53:7265-7276. [PMID: 37185055 DOI: 10.1017/s0033291723000806] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND Tobacco is a highly prevalent substance of abuse in patients with psychosis. Previous studies have reported an association between tobacco use and schizophrenia. The aim of this study was to analyze the relationship between tobacco use and first-episode psychosis (FEP), age at onset of psychosis, and specific diagnosis of psychosis. METHODS The sample consisted of 1105 FEP patients and 1355 controls from the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study. We assessed substance use with the Tobacco and Alcohol Questionnaire and performed a series of regression analyses using case-control status, age of onset of psychosis, and diagnosis as outcomes and tobacco use and frequency of tobacco use as predictors. Analyses were adjusted for sociodemographic characteristics, alcohol, and cannabis use. RESULTS After controlling for cannabis use, FEP patients were 2.6 times more likely to use tobacco [p ⩽ 0.001; adjusted odds ratio (AOR) 2.6; 95% confidence interval (CI) [2.1-3.2]] and 1.7 times more likely to smoke 20 or more cigarettes a day (p = 0.003; AOR 1.7; 95% CI [1.2-2.4]) than controls. Tobacco use was associated with an earlier age at psychosis onset (β = -2.3; p ⩽ 0.001; 95% CI [-3.7 to -0.9]) and was 1.3 times more frequent in FEP patients with a diagnosis of schizophrenia than in other diagnoses of psychosis (AOR 1.3; 95% CI [1.0-1.8]); however, these results were no longer significant after controlling for cannabis use. CONCLUSIONS Tobacco and heavy-tobacco use are associated with increased odds of FEP. These findings further support the relevance of tobacco prevention in young populations.
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Affiliation(s)
- T Sánchez-Gutiérrez
- Faculty of Health Science, Universidad Internacional de la Rioja (UNIR), Logroño, Spain
| | - E Rodríguez-Toscano
- Grupo de investigación en Psiquiatría, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
- Department of Experimental Psychology, Cognitive Processes and Speech Therapy at the Complutense University of Madrid, Madrid, Spain
| | - L Roldán
- Faculty of Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - L Ferraro
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - M Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - A Calvo
- Faculty of Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - G López
- Faculty of Health Science, Universidad Internacional de la Rioja (UNIR), Logroño, Spain
| | - M Rapado-Castro
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, Victoria 3053, Australia
| | - D La Barbera
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - C La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - G Tripoli
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - M Di Forti
- Department of Social Genetics and Developmental Psychiatry, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Mental Health Trust, London, UK
| | - R M Murray
- Department of Social Genetics and Developmental Psychiatry, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
| | - D Quattrone
- Department of Social Genetics and Developmental Psychiatry, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
| | - C Morgan
- ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - J van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands
- Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - P García-Portilla
- Department of Medicine-Psychiatry, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - S Al-Halabí
- Department of Psychology, University of Oviedo, Oviedo, Spain
| | - J Bobes
- Department of Medicine-Psychiatry, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - L de Haan
- Early Psychosis Department, Amsterdam UMC, University of Amsterdam, Academic Psychiatric Centre, Arkin, Amsterdam, The Netherlands
| | - M Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERSAM, ISCIII, Barcelona, Spain
| | - J L Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital 'Virgen de la Luz', Cuenca, Spain
| | - J Sanjuán
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, INCLIVA, CIBERSAM, School of Medicine, Universidad de Valencia, Valencia, Spain
| | - M Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - A Ferchiou
- Fondation FondaMental, Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France
- AP-HP, Hopitaux Universitaires 'H. Mondor', DMU IMPACT, F-94010 Creteil, France
| | - A Szoke
- Fondation FondaMental, Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France
- AP-HP, Hopitaux Universitaires 'H. Mondor', DMU IMPACT, F-94010 Creteil, France
| | - B P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - S Stilo
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
| | - G D'Andrea
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - I Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - C M Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - C Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
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6
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Tyler Rogers R, Marino L, Scodes J, Wall M, Nossel I, Dixon L. Prevalance and course of tobacco use among individuals receiving coordinated specialty care for first-episode psychosis. Early Interv Psychiatry 2023; 17:192-201. [PMID: 35751414 PMCID: PMC9789203 DOI: 10.1111/eip.13320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 04/18/2022] [Accepted: 05/29/2022] [Indexed: 01/24/2023]
Abstract
AIM Tobacco use is decreasing among the general population, but persistent use among individuals in treatment for first-episode psychosis (FEP) remains a problem. This study aimed to measure the prevalence and course of tobacco use and explore the associations between tobacco use and clinical outcomes in a FEP sample located in New York State (NYS). METHODS Participants (N = 870) were from the OnTrackNY system of coordinated specialty care clinics in NYS. Participant data were collected at admission to the program and at every 3 months of follow-up using standardized forms based on reports from clients, client families and chart review. Course of tobacco use was categorized into four groups: no-use, cessation, persistent and initiation over 1 year of follow-up. RESULTS The prevalence of tobacco use was 12.8% at baseline and 19.9% at 1-year follow-up. Only 3.8% of tobacco users stopped by 1 year follow-up, and 4.9% initiated use. Urbanicity of clinic location (p < .001); age at admission (p = .044); gender (p = .015); ethnoracial group (p = .007); baseline education/employment status (p = .004); and baseline use of any non-tobacco substances (p < .001), including alcohol (p < .001) and cannabis (p < .001), were associated with tobacco course. Findings suggest an association between tobacco use and reduced improvement in symptoms. CONCLUSION Despite a lower prevalence of tobacco use among OnTrack participants than in other comparable samples, tobacco cessation was minimal and more individuals initiated tobacco use than ceased over the course of follow-up. Efforts to implement tobacco cessation interventions in coordinated specialty care are warranted, since tobacco use is associated with poor health outcomes.
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Affiliation(s)
- R. Tyler Rogers
- New York State Psychiatric Institute, New York, NY, 1051 Riverside Drive, New York, NY, USA 10032
| | - Leslie Marino
- New York State Psychiatric Institute, New York, NY, 1051 Riverside Drive, New York, NY, USA 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, USA 10032
| | - Jennifer Scodes
- New York State Psychiatric Institute, New York, NY, 1051 Riverside Drive, New York, NY, USA 10032
| | - Melanie Wall
- New York State Psychiatric Institute, New York, NY, 1051 Riverside Drive, New York, NY, USA 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, USA 10032
| | - Ilana Nossel
- New York State Psychiatric Institute, New York, NY, 1051 Riverside Drive, New York, NY, USA 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, USA 10032
| | - Lisa Dixon
- New York State Psychiatric Institute, New York, NY, 1051 Riverside Drive, New York, NY, USA 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, USA 10032
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7
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Coentre R, Levy P, Góis C, Figueira ML. Metabolic syndrome following a first episode of psychosis: results of a 1-year longitudinal study conducted in metropolitan Lisbon, Portugal. J Int Med Res 2022; 50:3000605221106703. [PMID: 35726606 PMCID: PMC9218473 DOI: 10.1177/03000605221106703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective We aimed to assess the prevalence and course of metabolic syndrome (MetS) and the associated metabolic parameters during the year following a first episode pf psychosis (FEP). Methods We performed a 1-year longitudinal observation of 60 patients who experienced FEP. MetS was defined using the modified definition of the National Cholesterol Education Program Adult Treatment Panel III. We assessed the metabolic parameters and socio-demographic and psychopathological data for the participants. Results The mean age of the participants was 27.1 years, and 33.3% of them were women. There was an increase in the prevalence of MetS from 6.7% to 11.7% during the year following the baseline assessment during the year following the baseline assessment (p = 0.250). There were also significant increases in the prevalences of abnormal triglyceride concentration, waist circumference, and high-density lipoprotein (HDL)-cholesterol concentration during this period. In addition, there was a considerable worsening of the metabolic profile of the participants. No baseline parameters were identified to be predictors of MetS over the 1-year follow-up period. Conclusions We can conclude that metabolic abnormalities are common in patients with FEP and that these rapidly worsen during the first year following the diagnosis of FEP. Studies on interventions are needed to reduce metabolic risk to cardiovascular diseases following the FEP.
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Affiliation(s)
- Ricardo Coentre
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Department of Psychiatry, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - Pedro Levy
- Department of Psychiatry, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - Carlos Góis
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Department of Psychiatry, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
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8
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Gjerde PB, Steen SW, Vedal TSJ, Steen NE, Reponen EJ, Andreassen OA, Steen VM, Melle I. Lifetime Cannabis Use Is Not Associated With Negative Beliefs About Medication in Patients With First Treatment Psychosis. Front Psychiatry 2022; 13:824051. [PMID: 35422717 PMCID: PMC9001842 DOI: 10.3389/fpsyt.2022.824051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 03/07/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Cannabis use is common among patients with psychosis, and along with negative beliefs about medication, it has been found to predict poor adherence to antipsychotic drug treatment. Such lack of adherence to antipsychotic drug treatment increases the risk of poor clinical outcomes and relapse in patients with first treatment for psychosis (FTP). However, to date, it is unclear whether cannabis use may be related to negative perceptions about antipsychotic drug treatment. METHODS A cross-sectional sample of 265 FTP patients with schizophrenia spectrum disorder underwent extensive clinical assessments. Three measures of cannabis use were obtained: lifetime, current and meeting diagnostic criteria for abuse or addiction. For the primary analyses we focused on lifetime cannabis use. The Beliefs about Medication Questionnaire (BMQ) was employed to assess the patients' specific concerns and perceptions of antipsychotic medications, as well as general beliefs about pharmacotherapy. The relationship between lifetime cannabis use and BMQ scores was investigated with general linear model (GLM) analyses, controlling for age and sex. RESULTS Patients with lifetime use of cannabis ≥10 times were more likely to be male, younger at the age of onset of psychosis and with higher levels of alcohol use and daily tobacco smoking, as compared to the non-users (p < 0.05). Neither lifetime use of cannabis, current use nor a cannabis abuse diagnosis was associated with negative beliefs about medicines as measured by the BMQ questionnaire. CONCLUSION Use of cannabis is not linked to negative perceptions about antipsychotic medicines in patients with FTP. Other reasons for poor compliance to antipsychotic drug treatment in cannabis users need to be further investigated.
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Affiliation(s)
- Priyanthi B Gjerde
- Norwegian Centre for Mental Disorders Research, Department of Clinical Science, University of Bergen, Bergen, Norway.,Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway.,Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway
| | - Synne W Steen
- Norwegian Centre for Mental Disorders Research, Department of Clinical Science, University of Bergen, Bergen, Norway.,Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| | - Trude S J Vedal
- Division of Mental Health, Akershus University Hospital, Oslo, Norway.,NORMENT, Oslo University Hospital, Oslo, Norway
| | - Nils Eiel Steen
- NORMENT, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Ole A Andreassen
- NORMENT, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Vidar M Steen
- Norwegian Centre for Mental Disorders Research, Department of Clinical Science, University of Bergen, Bergen, Norway.,Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| | - Ingrid Melle
- NORMENT, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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9
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Impact of previous tobacco use with or without cannabis on first psychotic experiences in patients with first-episode psychosis. Schizophr Res 2021; 236:19-28. [PMID: 34365082 DOI: 10.1016/j.schres.2021.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 02/14/2021] [Accepted: 07/12/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE There is high prevalence of cigarette smoking in individuals with first-episode psychosis (FEP) prior to psychosis onset. The purpose of the study was to determine the impact of previous tobacco use with or without cannabis on first psychotic experiences in FEP and the impact of this use on age of onset of symptoms, including prodromes. METHODS Retrospective analyses from the naturalistic, longitudinal, multicentre, "Phenotype-Genotype and Environmental Interaction. Application of a Predictive Model in First Psychotic Episodes (PEPs)" Study. The authors analysed sociodemographic/clinical data of 284 FEP patients and 231 matched healthy controls, and evaluated first psychotic experiences of patients using the Symptom Onset in Schizophrenia Inventory. RESULTS FEP patients had significantly higher prevalence of tobacco, cannabis, and cocaine use than controls. The FEP group with tobacco use only prior to onset (N = 56) had more sleep disturbances (42.9% vs 18.8%, P = 0.003) and lower prevalence of negative symptoms, specifically social withdrawal (33.9% vs 58%, P = 0.007) than FEP with no substance use (N = 70), as well as lower prevalence of ideas of reference (80.4% vs 92.4%, P = 0.015), perceptual abnormalities (46.4% vs 67.4%, P = 0.006), hallucinations (55.4% vs 71.5%, P = 0.029), and disorganised thinking (41.1% vs 61.1%, P = 0.010) than FEP group with previous tobacco and cannabis use (N = 144). FEP patients with cannabis and tobacco use had lower age at first prodromal or psychotic symptom (mean = 23.73 years [SD = 5.09]) versus those with tobacco use only (mean = 26.21 [SD = 4.80]) (P = 0.011). CONCLUSIONS The use of tobacco alone was not related to earlier age of onset of a first psychotic experience, but the clinical profile of FEP patients is different depending on previous tobacco use with or without cannabis.
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10
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van der Heijden HS, Schirmbeck F, Kempton MJ, van der Gaag M, Allot K, Nelson B, Ruhrmann S, de Haan L, Vermeulen JM. Impact of smoking Behavior on cognitive functioning in persons at risk for psychosis and healthy controls: A longitudinal study. Eur Psychiatry 2021; 64:e60. [PMID: 34544507 PMCID: PMC8516743 DOI: 10.1192/j.eurpsy.2021.2233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background The high prevalence of smoking in individuals who are at ultra-high risk (UHR) for psychosis is well known and moderate cognitive deficits have also been found in UHR. However, the association between smoking and cognition in UHR is unknown and longitudinal studies are lacking. Method A cohort study with 330 UHR individuals and 66 controls was conducted, as part of the European network of national schizophrenia networks studying gene–environment interactions (EU-GEI). At baseline and after 6, 12, and 24 months, smoking behavior was assessed with the Composite International Diagnostic Interview and cognitive functioning with a comprehensive test battery. Linear mixed-effects analyses were used to examine the multicross-sectional and prospective associations between (change in) smoking behavior and cognitive functioning, accounting for confounding variables. Results At baseline, 53% of UHR and 27% of controls smoked tobacco. Smoking UHR and controls did not significantly differ from nonsmoking counterparts on the tested cognitive domains (speed of processing, attention/vigilance, working memory, verbal learning, or reasoning/problem solving) across different assessment times. Neither smoking cessation nor initiation was associated with a significant change in cognitive functioning in UHR. Conclusions No associations were found between smoking and cognitive impairment in UHR nor in controls. However, the fact that one in every two UHR individuals report daily use of tobacco is alarming. Our data suggest that UHR have fewer cognitive impairments and higher smoking cessation rates compared to patients with first-episode psychosis found in literature. Implications to promote smoking cessation in the UHR stage need further investigation.
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Affiliation(s)
| | - Frederike Schirmbeck
- Department of Psychiatry, Amsterdam UMC (location AMC), Amsterdam, The Netherlands.,Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Mark van der Gaag
- Psychosis Research Institute, Parnassia Group, Hague, The Netherlands.,Department of Clinical Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Kelly Allot
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam UMC (location AMC), Amsterdam, The Netherlands.,Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | - Jentien M Vermeulen
- Department of Psychiatry, Amsterdam UMC (location AMC), Amsterdam, The Netherlands
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11
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Stiles E, Alcover KC, Stiles B, Oluwoye O, McDonell MG. Cannabis use and metabolic syndrome among clients with first episode psychosis. Early Interv Psychiatry 2021; 15:1051-1055. [PMID: 32881419 PMCID: PMC7921202 DOI: 10.1111/eip.13030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 07/09/2020] [Accepted: 08/02/2020] [Indexed: 02/06/2023]
Abstract
AIM To explore the relationship between cannabis use and metabolic syndrome (MetS) among those who have experienced first episode psychosis (FEP). METHODS A retrospective analysis of 404 participants enrolled in the Recovery After Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP) was conducted. Using multiple logistic regression, we investigated the correlation between cannabis use and rate of MetS at baseline and across time as well as the specific metabolic derangements among cannabis users and abstainers. RESULTS Although cannabis users had similar rates of MetS at baseline when compared with abstainers, those who used cannabis at any time during the study period tended to have lower triglycerides and elevated high-density lipoprotein (HDL). Cannabis users were less likely to develop MetS, relative to nonusers. CONCLUSIONS Cannabis use may be associated with lower incidence of MetS in patients who have experienced FEP. Further research is indicated to develop these observations.
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Affiliation(s)
- Erik Stiles
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA
| | - Karl C Alcover
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA
| | - Bryan Stiles
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Oladunni Oluwoye
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA.,Washington State Center of Excellence in Early Psychosis, Spokane, Washington, USA
| | - Michael G McDonell
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA.,Washington State Center of Excellence in Early Psychosis, Spokane, Washington, USA
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12
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Smoking Is Related to Reduced Motivation, But Not Global Cognition, in the First Two Years of Treatment for First Episode Psychosis. J Clin Med 2021; 10:jcm10081619. [PMID: 33920376 PMCID: PMC8069411 DOI: 10.3390/jcm10081619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 11/17/2022] Open
Abstract
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.
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13
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Ferreira A, Coentre R. A systematic review of tobacco use in first-episode psychosis. EUROPEAN JOURNAL OF PSYCHIATRY 2020. [DOI: 10.1016/j.ejpsy.2020.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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14
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Chenary R, Saeedfiroozabadi M, Shirmohammadi-Khorram N. Nicotine Dependence Status and Related Demographic Patterns in Cigarette and Water Pipe Consumers in Bushehr City. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2020. [DOI: 10.29252/jech.7.3.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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15
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Saugo E, Lasalvia A, Bonetto C, Cristofalo D, Poli S, Bissoli S, Bertani M, Lazzarotto L, Gardellin F, Ceccato E, Pavanati M, Tosato S, Ruggeri M. Dietary habits and physical activity in first-episode psychosis patients treated in community services. Effect on early anthropometric and cardio-metabolic alterations. Schizophr Res 2020; 216:374-381. [PMID: 31806524 DOI: 10.1016/j.schres.2019.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/27/2019] [Accepted: 11/05/2019] [Indexed: 01/08/2023]
Abstract
People with psychosis often develop metabolic and cardiovascular disorders, due to several factors including unhealthy lifestyle and antipsychotic treatment. This study aims to evaluate in a sample of first episode psychosis (FEP) patients lifestyle factors, with a specific emphasis on dietary habits and physical activity, and cardio-metabolic and anthropometric profile at illness onset and at 9 months. Moreover, this study aims to evaluate the impact of lifestyle factors on short term changes in cardio-metabolic and anthropometric profile. A 9-month follow-up study was conducted on a sample of 96 FEP patients recruited within the context of the GET UP program. Standardised assessments of dietary habits (EPIC) and physical activity (IPAQ) were retrospectively performed at 9 months; cardiovascular measures (blood pressure, heart rate), metabolic parameters (glucose, cholesterol, triglycerides), BMI and antipsychotic treatment were assessed at illness onset and at 9 months. We found that most FEP patients (60%) displayed poor dietary habits, as defined in terms of adherence to the Mediterranean diet. A significant increase for both BMI and cholesterol levels was found in the overall sample over 9 months. However, when considering the effect of lifestyle factors, BMI and total cholesterol were specifically raised in patients with low adherence to Mediterranean diet. The association with antipsychotic medication was found for SGA only, with a significant increase in both BMI and total cholesterol overtime. Our findings confirm the need to implement specific and early strategies to promote healthy lifestyle in people with FEP, since metabolic alterations occur within the first months of treatment.
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Affiliation(s)
- Elena Saugo
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy; UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Italy.
| | - Chiara Bonetto
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Doriana Cristofalo
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Sara Poli
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Sarah Bissoli
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Mariaelena Bertani
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Lorenza Lazzarotto
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy
| | | | - Enrico Ceccato
- Dipartimento di Salute Mentale, Azienda ULSS 8 Berica, Vicenza, Italy
| | - Michele Pavanati
- Dipartimento di Salute Mentale e Dipendenze Patologiche, AUSL Ferrara, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy; UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Italy
| | - Mirella Ruggeri
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy; UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Italy
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16
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Sagayadevan V, Abdin E, Shahwan S, Satghare P, Devi F, Cetty L, Sendren JR, Verma SK, Chong SA, Subramaniam M. Motivations to quit smoking and challenges faced during cessation among individuals with first episode psychosis in Singapore. Early Interv Psychiatry 2019; 13:1488-1494. [PMID: 30919587 PMCID: PMC6899675 DOI: 10.1111/eip.12799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 11/17/2018] [Accepted: 02/17/2019] [Indexed: 11/29/2022]
Abstract
AIMS The prevalence of smoking has been noted to be higher among individuals with mental illness, particularly among those with schizophrenia and related psychosis than in the general population. The present paper sought to examine the motivations and challenges to quit smoking among first episode psychosis patients (N = 281) enrolled in the Early Psychosis Intervention Programme (EPIP) in Singapore. METHODS Questionnaires were used to collect details on an individual's smoking status, cessation attempts, motivations to quit, and challenges to stop smoking. Using baseline data, multiple linear regressions were conducted to examine the socio-demographic correlates of motivations and challenges of smoking cessation behaviour. RESULTS Of the study sample, 59.4% reported to have never smoked while 39.9% were currently smoking or had attempted smoking. Health reasons and cost were the most highly endorsed motivations to stop smoking; whereas cravings, stress, and boredom were highly endorsed as challenges to stop smoking. Socio-demographic factors such as age, educational level, and marital status were also found to be associated with the motivations to stop smoking and challenges faced during smoking cessation. CONCLUSIONS The present study highlights the most highly endorsed motivations and challenges reported among individuals with first episode psychosis (FEP) in an Asian population. Given that the literature examining motivations and challenges to quit smoking has predominantly focused on the general population, results from the current study have implications for the formulation of smoking cessation programmes targeted at individuals with mental illness, particularly those with FEP.
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Affiliation(s)
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Pratika Satghare
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Laxman Cetty
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Jagan R Sendren
- Early Psychosis Intervention Programme (EPIP), Singapore, Singapore
| | - Swapna K Verma
- Early Psychosis Intervention Programme (EPIP), Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore.,Early Psychosis Intervention Programme (EPIP), Singapore, Singapore
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17
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Lally J, Spaducci G, Gardner-Sood P, Atakan Z, Greenwood K, Di Forti M, Ismail K, Murphy KC, Smith S, McNeill A, Murray RM, Gaughran F. Tobacco smoking and nicotine dependence in first episode and established psychosis. Asian J Psychiatr 2019; 43:125-131. [PMID: 31132542 DOI: 10.1016/j.ajp.2019.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 03/28/2019] [Accepted: 05/02/2019] [Indexed: 01/08/2023]
Abstract
AIM People with psychotic disorders have increased premature mortality in comparison with the general population, with high rates of cigarette use a contributing factor. We aimed to describe the prevalence of cigarette use and nicotine dependence (ND) in first episode psychosis (FEP), and established psychosis; and to investigate associations between clinical symptoms and ND. METHODOLOGY Smoking and clinical data were collected from two cohorts: 181 people with FEP recruited as part of the Physical Health and Substance Use Measures in First Onset Psychosis (PUMP) study and from 432 people with established psychosis recruited as part of the Improving physical health and reducing substance use in psychosis randomised controlled trial (IMPaCT RCT). RESULTS The prevalence of cigarette smoking was 78% in FEP and 62% in established psychosis. Forty nine percent (n = 60) of smokers in the FEP cohort and 69% (n = 183) of smokers with established psychosis were highly nicotine dependent. Being a highly nicotine dependent smoker was significantly associated with higher PANSS positive symptom scores (F = 5.480 p = 0.004), and with decreased scores on the Rosenberg self-esteem scale (F = 3.261, p = 0.039) in established psychosis. There was no diagnostic specificity identified in relation to smoking or ND in both groups. CONCLUSION High rates of cigarette usage and nicotine dependence are problems from the early stages of psychosis. ND is higher in people with established psychosis. Smoking cessation strategies as part of comprehensive management of psychotic disorders at every stage require further development and evaluation.
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Affiliation(s)
- John Lally
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, UK; Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland; Department of Psychiatry, School of Medicine and Medical Sciences, University College Dublin, St Vincent's University Hospital, Dublin, Ireland; St Vincent's Hospital Fairview, Dublin, Ireland.
| | - Gilda Spaducci
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, UK.
| | | | - Zerrin Atakan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, UK
| | - Kathryn Greenwood
- Sussex Partnership NHS Foundation Trust, School of Psychology, University of Sussex, Brighton, UK.
| | - Marta Di Forti
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK.
| | - Khalida Ismail
- Psychological Medicine Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, Denmark Hill, London, UK.
| | - Kieran C Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
| | - Shubulade Smith
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, Denmark Hill, London, UK; Forensic Intensive Care Service, South London and Maudsley NHS Foundation Trust, London, UK.
| | - Ann McNeill
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, UK.
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, UK; Department of Psychiatry, Experimental Biomedicine and Clinical Neuroscience (BIONEC), University of Palermo, Italy.
| | - Fiona Gaughran
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, UK; National Psychosis Service, South London and Maudsley NHS Foundation Trust, Reader, Institute of Psychiatry Psychology and Neuroscience, Kings College London, London, UK.
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18
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García-Álvarez L, García-Portilla MP, Caso JR, de la Fuente-Tomás L, González-Blanco L, Sáiz Martínez P, Leza JC, Bobes J. Early versus late stage schizophrenia. What markers make the difference? World J Biol Psychiatry 2019; 20:159-165. [PMID: 30295120 DOI: 10.1080/15622975.2018.1511920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To identify the psychopathological, cognitive, functional, physical health and inflammatory markers that differentiate between early-stage schizophrenia (ESSCH) and late-stage schizophrenia (LSSCH). METHODS Cross-sectional, naturalistic study of 104 patients with SCH. The sample was divided in two groups: 35 ESSCH (≤7 years' duration of illness) and 69 LSSCH (>10 years' duration of illness). STATISTICAL ANALYSIS chi-square test and Student's t-test and ANCOVA (or Quade test) controlling for age, sex, BMI and number of cigarettes/day. Finally, a binomial logistic regression was made. RESULTS ESSCH show greater negative symptom severity (t = 2.465, p = 0.015), lower levels of IκBα (F = 7.644, p = 0.007), were more frequently classified as normal weight (40% vs 18.8%, p = 0.032) compared with LSSCH. The binomial logistic regression model included age (B = 0.127, p = 0.001) and IκBα (B = 0.025, p = 0.002) and accounted for 38.9% of the variance (model df =7, chi-square =41.841, p < 0.0001). CONCLUSIONS Age and IκBα are the unique markers that differentiate between ESSCH patients whose duration of illness is less than 7 years and LSSCH patients. These results support the hypothesis of toxicity of episodes and highlight the importance of preventing new episodes.
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Affiliation(s)
- L García-Álvarez
- a Fundación para la Investigación y la Innovación Biosanitaria del Principado de Asturias (FINBA), Spain.,b Centro de InvestigaciÆn BiomÅdica en Red de Salud Mental (CIBERSAM) , Spain.,c Área de Psiquiatría, Facultad de Medicina , Universidad de Oviedo , Oviedo , Spain.,d Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain
| | - M P García-Portilla
- a Fundación para la Investigación y la Innovación Biosanitaria del Principado de Asturias (FINBA), Spain.,b Centro de InvestigaciÆn BiomÅdica en Red de Salud Mental (CIBERSAM) , Spain.,c Área de Psiquiatría, Facultad de Medicina , Universidad de Oviedo , Oviedo , Spain.,d Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain.,e Servicio de Salud del Principado de Asturias, SESPA , Spain
| | - J R Caso
- b Centro de InvestigaciÆn BiomÅdica en Red de Salud Mental (CIBERSAM) , Spain.,f Departamento de Farmacología, Facultad de Medicina , Universidad Complutense de Madrid (UCM) , Madrid , Spain.,g Instituto de InvestigaciÆn Sanitaria Hospital ab de Octubre (imasab) , Madrid , Spain.,h Instituto Universitario de InvestigaciÆn en NeuroquÕmica UCM , Madrid , Spain
| | - L de la Fuente-Tomás
- b Centro de InvestigaciÆn BiomÅdica en Red de Salud Mental (CIBERSAM) , Spain.,c Área de Psiquiatría, Facultad de Medicina , Universidad de Oviedo , Oviedo , Spain.,d Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain
| | - L González-Blanco
- c Área de Psiquiatría, Facultad de Medicina , Universidad de Oviedo , Oviedo , Spain.,e Servicio de Salud del Principado de Asturias, SESPA , Spain
| | - P Sáiz Martínez
- a Fundación para la Investigación y la Innovación Biosanitaria del Principado de Asturias (FINBA), Spain.,b Centro de InvestigaciÆn BiomÅdica en Red de Salud Mental (CIBERSAM) , Spain.,c Área de Psiquiatría, Facultad de Medicina , Universidad de Oviedo , Oviedo , Spain.,d Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain.,e Servicio de Salud del Principado de Asturias, SESPA , Spain
| | - J C Leza
- b Centro de InvestigaciÆn BiomÅdica en Red de Salud Mental (CIBERSAM) , Spain.,f Departamento de Farmacología, Facultad de Medicina , Universidad Complutense de Madrid (UCM) , Madrid , Spain.,g Instituto de InvestigaciÆn Sanitaria Hospital ab de Octubre (imasab) , Madrid , Spain.,h Instituto Universitario de InvestigaciÆn en NeuroquÕmica UCM , Madrid , Spain
| | - J Bobes
- a Fundación para la Investigación y la Innovación Biosanitaria del Principado de Asturias (FINBA), Spain.,b Centro de InvestigaciÆn BiomÅdica en Red de Salud Mental (CIBERSAM) , Spain.,c Área de Psiquiatría, Facultad de Medicina , Universidad de Oviedo , Oviedo , Spain.,d Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain.,e Servicio de Salud del Principado de Asturias, SESPA , Spain
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19
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Vancampfort D, De Hert M, Myin-Germeys I, van Winkel R, Firth J, Van Damme T, Probst M. Lower cardiorespiratory fitness is associated with more time spent sedentary in first episode psychosis: A pilot study. Psychiatry Res 2017; 253:13-17. [PMID: 28319786 DOI: 10.1016/j.psychres.2017.03.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 03/05/2017] [Accepted: 03/13/2017] [Indexed: 11/16/2022]
Abstract
Patients with a psychotic disorder show lower cardiorespiratory fitness and higher mortality rates compared to healthy individuals. The aim of this cross-sectional study was to explore whether in patients with first-episode psychosis a low cardiorespiratory fitness is associated with decreased physical activity and increased sedentary levels. Twenty-nine outpatients (21 men; 22.8±5.1 years) performed a maximal exercise test to assess their maximum oxygen uptake (VO2max), wore a Senswear armband for five consecutive days and were assessed with the Positive and Negative Syndrome Scale. Twenty-four patients (82.8%) scored below the normative cardiorespiratory values. The percent-predicted VO2max ranged from 47% to 109%. In a backward regression analysis, less time spent sedentary (min/day) was the only independent predictor of a higher VO2max. The model explained 28.0% of the variance in the VO2max-score. The current study indicates that future research should explore whether reducing sedentary behaviour (e.g. time spent napping or prolonged sitting during waking hours) might improve cardio-respiratory fitness levels. Interventions targeting recreational screen time (watching television, computer use, playing video games, etc.) or replacing passive to more active video games should be investigated.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; UPC KU Leuven, Kortenberg-Leuven, Belgium.
| | | | - Inez Myin-Germeys
- KU Leuven Department of Neurosciences, Centre for Contextual Psychiatry, Leuven, Belgium
| | - Ruud van Winkel
- UPC KU Leuven, Kortenberg-Leuven, Belgium; KU Leuven Department of Neurosciences, Centre for Contextual Psychiatry, Leuven, Belgium
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; UPC KU Leuven, Kortenberg-Leuven, Belgium
| | - Michel Probst
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; UPC KU Leuven, Kortenberg-Leuven, Belgium
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