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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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Mallet J, Godin O, Dansou Y, Mazer N, Scognamiglio C, Berna F, Boyer L, Capdevielle D, Chéreau I, D'Amato T, Dubreucq J, Fond G, Leigner S, Llorca PM, Misdrahi D, Passerieux C, Rey R, Pignon B, Urbach M, Schorr B, Schürhoff F, Yann LS, Dubertret C. Current (but not ex) cigarette smoking is associated with worse cognitive performances in schizophrenia: results from the FACE-SZ cohort. Psychol Med 2023; 53:5279-5290. [PMID: 36073848 DOI: 10.1017/s0033291722002574] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Tobacco use is common in subjects with schizophrenia (SZ) and has sometimes been associated with better functioning in short-term studies. Only few studies embrace an extensive examination of tobacco influence on clinical, cognitive and therapeutic characteristics in stabilized SZ outpatients. The objective of the present study was to assess the association between cognitive performances and smoking status in SZ subjects. METHODS In total, 1233 SZ participants (73.9% men, mean age 31.5) were included and tested with a comprehensive battery. Tobacco status was self-declared (never-, ex-, or current smokers). Multivariable analyses including principal component analyses (PCA) were used. RESULTS In total, 53.7% were smokers with 33.7% of them nicotine-dependent. Multiple factor analysis revealed that current tobacco smoking was associated with impaired general intellectual ability and abstract reasoning (aOR 0.60, 95% IC 0.41-0.88, p = 0.01) and with a lifetime alcohol use disorder (p = 0.026) and a lifetime cannabis use disorder (p < 0.001). Ex- and never-smokers differed for age, mean outcome, cannabis history and medication [ex-smokers being older (p = 0.047), likely to have higher income (p = 0.026), a lifetime cannabis use disorder (p < 0.001) and higher CPZeq doses (p = 0.005)]. Premorbid IQ in the three groups significantly differed with, from higher to lower: ex-smokers, never-smoker, current smokers (all p < 0.001). CONCLUSIONS This study is the largest to date providing strong evidence that chronic smoking is associated with cognitive impairment in SZ, arguing against the self-medication hypothesis as a contributor to the high prevalence of smoking in SZ. Ex-smokers may also represent a specific subgroup. Longitudinal studies are warranted to determine the developmental impact of tobacco on neurocognition.
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Affiliation(s)
- Jasmina Mallet
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- Fondation Fondamental, Créteil, France
| | - Ophélia Godin
- Fondation Fondamental, Créteil, France
- Université Paris-Est, UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de psychiatrie, Créteil, France Fondation FondaMental, fondation de cooperation scientifique, Créteil, France
| | | | - Nicolas Mazer
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- Fondation Fondamental, Créteil, France
| | - Claire Scognamiglio
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- Fondation Fondamental, Créteil, France
| | - Fabrice Berna
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Laurent Boyer
- AP-HM, Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Delphine Capdevielle
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Isabelle Chéreau
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Thierry D'Amato
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Julien Dubreucq
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, France
| | - Guillaume Fond
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- AP-HM, Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Sylvain Leigner
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, France
| | - Pierre-Michel Llorca
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - David Misdrahi
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France
- University of Bordeaux, Laboratory of Nutrition and Integrative Neurobiology (UMR INRA 1286), Bordeaux, France
| | - Christine Passerieux
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Department of Adult Psychiatry and Addictology, Versailles Hospital, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France
- DisAP-DevPsy-CESP, INSERM UMR1018, University of Paris-Saclay, University of Versailles Saint-Quentin-En-Yvelines 94807, Villejuif, France
| | - Romain Rey
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Baptiste Pignon
- Université Paris-Est, UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de psychiatrie, Créteil, France Fondation FondaMental, fondation de cooperation scientifique, Créteil, France
| | - Mathieu Urbach
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Department of Adult Psychiatry and Addictology, Versailles Hospital, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France
- DisAP-DevPsy-CESP, INSERM UMR1018, University of Paris-Saclay, University of Versailles Saint-Quentin-En-Yvelines 94807, Villejuif, France
| | - Benoit Schorr
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Franck Schürhoff
- Université Paris-Est, UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de psychiatrie, Créteil, France Fondation FondaMental, fondation de cooperation scientifique, Créteil, France
| | - Le Strat Yann
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- Fondation Fondamental, Créteil, France
| | - Caroline Dubertret
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- Fondation Fondamental, Créteil, France
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Smoking Habits and Attitudes toward Smoking in Patients with Severe Mental Illness in Residential Facilities in Insular Greece. Healthcare (Basel) 2023; 11:healthcare11050642. [PMID: 36900647 PMCID: PMC10001183 DOI: 10.3390/healthcare11050642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/14/2023] [Accepted: 02/19/2023] [Indexed: 02/24/2023] Open
Abstract
Smoking may contribute to increased cardiovascular morbidity and mortality in patients with schizophrenia spectrum disorders. The objective of the present study is to explore the attitudes toward smoking in patients with severe mental illness in residential rehabilitation facilities in insular Greece. The patients (n = 103) were studied with the use of a questionnaire based on a semi-structured interview. Most of the participants (68.3%) were current regular smokers, had been smoking for 29 years and started smoking at an early age. The majority (64.8%) reported having tried to quit smoking in the past, and only half had been advised by a physician to quit. The patients agreed on the rules for smoking and believed that the staff should avoid smoking in the facility. The years of smoking were statistically significantly correlated to the educational level and the treatment with antidepressant medication. A statistical analysis showed that longer stay period in the facilities correlates with current smoking, an effort to quit and increased belief that smoking causes harm to health. Further research on the attitudes of patients in residential facilities toward smoking is needed, which could guide interventions for smoking cessation and should be assumed by all health professionals who are involved in the care of those patients.
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Dobre D, Schwan R, Jansen C, Schwitzer T, Martin O, Ligier F, Rolland B, Ahad PA, Capdevielle D, Corruble E, Delamillieure P, Dollfus S, Drapier D, Bennabi D, Joubert F, Lecoeur W, Massoubre C, Pelissolo A, Roser M, Schmitt C, Teboul N, Vansteene C, Yekhlef W, Yrondi A, Haoui R, Gaillard R, Leboyer M, Thomas P, Gorwood P, Laprevote V. Clinical features and outcomes of COVID-19 patients hospitalized for psychiatric disorders: a French multi-centered prospective observational study. Psychol Med 2023; 53:342-350. [PMID: 33902760 PMCID: PMC8144831 DOI: 10.1017/s0033291721001537] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/31/2021] [Accepted: 04/07/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Patients with psychiatric disorders are exposed to high risk of COVID-19 and increased mortality. In this study, we set out to assess the clinical features and outcomes of patients with current psychiatric disorders exposed to COVID-19. METHODS This multi-center prospective study was conducted in 22 psychiatric wards dedicated to COVID-19 inpatients between 28 February and 30 May 2020. The main outcomes were the number of patients transferred to somatic care units, the number of deaths, and the number of patients developing a confusional state. The risk factors of confusional state and transfer to somatic care units were assessed by a multivariate logistic model. The risk of death was analyzed by a univariate analysis. RESULTS In total, 350 patients were included in the study. Overall, 24 (7%) were transferred to medicine units, 7 (2%) died, and 51 (15%) patients presented a confusional state. Severe respiratory symptoms predicted the transfer to a medicine unit [odds ratio (OR) 17.1; confidence interval (CI) 4.9-59.3]. Older age, an organic mental disorder, a confusional state, and severe respiratory symptoms predicted mortality in univariate analysis. Age >55 (OR 4.9; CI 2.1-11.4), an affective disorder (OR 4.1; CI 1.6-10.9), and severe respiratory symptoms (OR 4.6; CI 2.2-9.7) predicted a higher risk, whereas smoking (OR 0.3; CI 0.1-0.9) predicted a lower risk of a confusional state. CONCLUSION COVID-19 patients with severe psychiatric disorders have multiple somatic comorbidities and have a risk of developing a confusional state. These data underline the need for extreme caution given the risks of COVID-19 in patients hospitalized for psychiatric disorders.
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Affiliation(s)
- Daniela Dobre
- Centre Psychothérapique de Nancy, LaxouF-54520, France
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, StrasbourgF-67 000, France
| | - Raymund Schwan
- Centre Psychothérapique de Nancy, LaxouF-54520, France
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, StrasbourgF-67 000, France
- Faculté de Médecine, Université de Lorraine, F-54500Vandoeuvre-lès-Nancy, France
| | - Claire Jansen
- Centre Psychothérapique de Nancy, LaxouF-54520, France
- Faculté de Médecine, Université de Lorraine, F-54500Vandoeuvre-lès-Nancy, France
| | - Thomas Schwitzer
- Centre Psychothérapique de Nancy, LaxouF-54520, France
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, StrasbourgF-67 000, France
- Faculté de Médecine, Université de Lorraine, F-54500Vandoeuvre-lès-Nancy, France
| | | | - Fabienne Ligier
- Centre Psychothérapique de Nancy, LaxouF-54520, France
- Faculté de Médecine, Université de Lorraine, F-54500Vandoeuvre-lès-Nancy, France
- EA 4360 APEMAC, Université de Lorraine, F-54500Vandoeuvre-lès-Nancy, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France
- Services hospitalo-universitaires d'addictologie, Hospices Civils de Lyon, Lyon, France
- Université de Lyon, UCBL, Centre de recherche en neurosciences de Lyon (CRNL), INSERM U1028, CNRS UMR5292, PSYR2, Bron, France
| | - Pierre Abdel Ahad
- Pôle hospitalo-universitaire de psychiatrie adultes Paris 15ème, GHU Paris psychiatrie et neurosciences, site Sainte-Anne, Paris, France
| | - Delphine Capdevielle
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
- University Department of Adult Psychiatry, CHU, Montpellier, France
| | - Emmanuelle Corruble
- Université department of Adult Psychiatry, Hôpital La Colombière, CHU de Montpellier, France
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin BicêtreF-94275, France
| | - Pascal Delamillieure
- CHU de Caen, Service de psychiatrie, Centre Esquirol, CaenF-14000, France
- Imagerie et Stratégies Thérapeutiques de la Schizophrénie (ISTS) EA 7466, Normandie Univ, GIP Cyceron, CaenF-14000, France
- UFR Santé, Normandie Univ, CaenF-14000, France
| | - Sonia Dollfus
- CHU de Caen, Service de psychiatrie, Centre Esquirol, CaenF-14000, France
- Imagerie et Stratégies Thérapeutiques de la Schizophrénie (ISTS) EA 7466, Normandie Univ, GIP Cyceron, CaenF-14000, France
- UFR Santé, Normandie Univ, CaenF-14000, France
| | - Dominique Drapier
- Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Centre Hospitalier Guillaume Régnier, RennesF-35703, France
- EA 47 12 Comportement et Noyaux Gris Centraux, Université Rennes 1, RennesF-35703, France
| | - Djamila Bennabi
- Service de psychiatrie de l'adulte, CHRU de Besançon, F-25000Besançon, France
- Centre expert dépression résistante FondaMental, F-25000Besançon, France
| | - Fabien Joubert
- Département d'Information Médicale, CH Le Vinatier, Bron, France
| | | | - Catherine Massoubre
- Service Universitaire de Psychiatrie, EA TAPE 7423, CHU de Saint-Etienne, Saint Etienne, France
| | - Antoine Pelissolo
- UPEC, Université Paris-Est, Faculté de médecine, CréteilF-94000, France
- AP-HP, DMU IMPACT, Hôpitaux universitaires Henri-Mondor, Service de Psychiatrie, CréteilF-94000, France
- INSERM U955, Laboratoire Neuro-Psychiatrie translationnelle, CréteilF-94000, France
| | - Mathilde Roser
- UPEC, Université Paris-Est, Faculté de médecine, CréteilF-94000, France
- AP-HP, DMU IMPACT, Hôpitaux universitaires Henri-Mondor, Service de Psychiatrie, CréteilF-94000, France
- INSERM U955, Laboratoire Neuro-Psychiatrie translationnelle, CréteilF-94000, France
| | - Christophe Schmitt
- Département d'Information Médicale, Centre Hospitalier de Jury, MetzF-57073, France
| | - Noé Teboul
- Département d'Information Médicale, CH Le Vinatier, Bron, France
| | - Clément Vansteene
- Clinique des Maladies Mentales et de l'Encéphale (CMME), Hôpital Sainte-Anne, 1 Rue Cabanis, 75014Paris, France
- INSERM U894, Centre de Psychiatrie et Neurosciences (CPN), Université Paris Descartes, PRES Sorbonne Paris Cité, Paris, France
| | - Wanda Yekhlef
- Département Soins Somatiques-Préventions-Santé Publique, Pôle CRISTALES, EPS de Ville-Evrard, Neuilly sur Marne, France
| | - Antoine Yrondi
- Service de Psychiatrie et de Psychologie Médicale, Centre Expert Dépression Résistante FondaMental, CHU de Toulouse, Hôpital Purpan, Toulouse, France
- ToNIC Toulouse NeuroImaging Center, Université de Toulouse, INSERM, UPS, Toulouse, France
| | - Radoine Haoui
- Pôle de Psychiatrie Générale Rive Gauche, Centre Hospitalier Gérard Marchant, F-31057Toulouse, France
| | - Raphaël Gaillard
- Pôle hospitalo-universitaire de psychiatrie adultes Paris 15ème, GHU Paris psychiatrie et neurosciences, site Sainte-Anne, Paris, France
- Université de Paris, Paris, France
- Human Histopathology and Animal Models, Infection and Epidemiology Department, Institut Pasteur, Paris, France
| | - Marion Leboyer
- UPEC, Université Paris-Est, Faculté de médecine, CréteilF-94000, France
- AP-HP, DMU IMPACT, Hôpitaux universitaires Henri-Mondor, Service de Psychiatrie, CréteilF-94000, France
- INSERM U955, Laboratoire Neuro-Psychiatrie translationnelle, CréteilF-94000, France
| | - Pierre Thomas
- Univ. Lille, INSERM U1172, CHU Lille, Centre Lille Neuroscience & Cognition (PSY), F-59000Lille, France
- CHU Lille, Pôle de Psychiatrie, F-59000Lille, France
| | - Philip Gorwood
- Clinique des Maladies Mentales et de l'Encéphale (CMME), Hôpital Sainte-Anne, 1 Rue Cabanis, 75014Paris, France
- Institute of Psychiatry and Neuroscience of Paris, University of Paris, INSERM U1266, Paris, France
- GHU Paris Psychiatrie et Neurosciences, CMME, Hôpital Sainte-Anne, Paris, France
| | - Vincent Laprevote
- Centre Psychothérapique de Nancy, LaxouF-54520, France
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, StrasbourgF-67 000, France
- Faculté de Médecine, Université de Lorraine, F-54500Vandoeuvre-lès-Nancy, France
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5
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Gary C, Déal C, Boursicot-Beuzelin J, Falissard B, Giordana JY, Fakra E, Samalin L, Bouju S. Initiation of quarterly palmitate paliperidone in French clinical practice: results from the observational, cross-sectional OPTIMUS study. Pharmacoepidemiol Drug Saf 2021; 31:334-342. [PMID: 34897888 DOI: 10.1002/pds.5397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/02/2021] [Accepted: 12/09/2021] [Indexed: 11/06/2022]
Abstract
PURPOSE Long-term antipsychotic treatment is key to a positive clinical outcome in schizophrenia. Recent guidelines recommend the prescription of long-acting antipsychotic formulations (LAIs) as early as the first episode in patients with schizophrenia. The OPTIMUS study evaluated real-world use of a new three-monthly paliperidone palmitate formulation (PP3M) in France. METHODS For this observational cross-sectional study, all French psychiatrists were invited to enrol patients who had initiated PP3M in the previous 4 months. Snapshot data were collected at a routine consultation, without any modification of clinical practice. RESULTS This population of 350 patients with schizophrenia started on PP3M predominantly included single men, living independently with a diagnosis of schizophrenia for a median of 9.3 years. Demographic characteristics were broadly comparable to those reported in other studies on LAIs. Investigators cited treatment simplification (96.9%) and patient comfort (93.3%) as the most common reasons for switching to PP3M; enhancing adherence was mentioned less often (61.1%) with most patients previously considered as adherent, and a majority of them expressing a positive attitude to their treatment. One-third of patients accepted the psychiatrist's proposal to initiate PP3M treatment without any discussion, and relatives were involved in the therapeutic decision-making process in only 23.7% of cases. After initiation, few changes were seen in professional follow-up frequency or concomitant pharmacological and non-pharmacological treatment modalities except for a decrease in antipsychotic polytherapy. CONCLUSIONS PP3M is mostly prescribed in adherent patients with fairly stable schizophrenia, and the longer dosing interval does not substantially affect patient care.
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Affiliation(s)
- Charlotte Gary
- Janssen, Medical Affairs Department, Issy-les-Moulineaux, France
| | - Cécile Déal
- Janssen, Medical Affairs Department, Issy-les-Moulineaux, France
| | | | | | - Jean-Yves Giordana
- Association Hospitalière Sainte-Marie - Centre Hospitalier Sainte-Marie, Nice, France
| | - Eric Fakra
- Centre Hospitalier Universitaire de Saint-Étienne, Hôpital de la Charité, Saint-Étienne, France
| | - Ludovic Samalin
- Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal (UMR 6602), Clermont-Ferrand, France
| | - Sophie Bouju
- Janssen, Medical Affairs Department, Issy-les-Moulineaux, France
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6
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Abstract
The α7-type nicotinic acetylcholine receptor is one of the most unique and interesting of all the members of the cys-loop superfamily of ligand-gated ion channels. Since it was first identified initially as a binding site for α-bungarotoxin in mammalian brain and later as a functional homomeric receptor with relatively high calcium permeability, it has been pursued as a potential therapeutic target for numerous indications, from Alzheimer disease to asthma. In this review, we discuss the history and state of the art for targeting α7 receptors, beginning with subtype-selective agonists and the basic pharmacophore for the selective activation of α7 receptors. A key feature of α7 receptors is their rapid desensitization by standard "orthosteric" agonist, and we discuss insights into the conformational landscape of α7 receptors that has been gained by the development of ligands binding to allosteric sites. Some of these sites are targeted by positive allosteric modulators that have a wide range of effects on the activation profile of the receptors. Other sites are targeted by direct allosteric agonist or antagonists. We include a perspective on the potential importance of α7 receptors for metabotropic as well as ionotropic signaling. We outline the challenges that exist for future development of drugs to target this important receptor and approaches that may be considered to address those challenges. SIGNIFICANCE STATEMENT: The α7-type nicotinic acetylcholine receptor (nAChR) is acknowledged as a potentially important therapeutic target with functional properties associated with both ionotropic and metabotropic signaling. The functional properties of α7 nAChR can be regulated in diverse ways with the variety of orthosteric and allosteric ligands described in this review.
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Affiliation(s)
- Roger L Papke
- Departments of Pharmacology and Therapeutics (R.L.P) and Chemistry (N.A.H.), University of Florida, Gainesville, FL
| | - Nicole A Horenstein
- Departments of Pharmacology and Therapeutics (R.L.P) and Chemistry (N.A.H.), University of Florida, Gainesville, FL
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7
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Buck JM, O'Neill HC, Stitzel JA. The Intergenerational Transmission of Developmental Nicotine Exposure-Induced Neurodevelopmental Disorder-Like Phenotypes is Modulated by the Chrna5 D397N Polymorphism in Adolescent Mice. Behav Genet 2021; 51:665-684. [PMID: 34159514 DOI: 10.1007/s10519-021-10071-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/07/2021] [Indexed: 12/01/2022]
Abstract
Maternal tobacco smoking during pregnancy constitutes developmental nicotine exposure (DNE) and is associated with nicotine dependence and neurodevelopmental disorders in both children and grandchildren as well as animal models thereof. Genetic variants such as the CHRNA5 single nucleotide polymorphism (SNP) rs16969968, which leads to an aspartic acid to asparagine substitution at amino acid position 398 (D398N) in the alpha-5 nicotinic acetylcholine receptor subunit, can also confer risk for nicotine dependence and neurodevelopmental disorders in the absence of DNE. However, the degrees to which, the consequences of maternal smoking on offspring outcomes are influenced by genetic variants and interactions therewith are not well understood. Addressing this void in the literature, the present study utilizes a DNE mouse model engineered to possess the equivalent of the human D398N SNP in CHRNA5 (D397N SNP in mice) to assess how the N397 risk allele impacts the induction and intergenerational transmission of a range of neurodevelopmental disorder-related behavioral phenotypes in first- and second-generation DNE offspring. Results reveal that offspring possessing the N397 variant in the absence of DNE as well as DNE offspring and grand offspring possessing theD397 variant exhibit analogous neurodevelopmental disorder-like phenotypes including hyperactivity, risk-taking behaviors, aberrant rhythmicity of activity, and enhanced nicotine consumption. DNE amplified these behavioral anomalies in first-generation N397 progeny, but the severity of DNE-evoked behavioral perturbations did not significantly differ between first-generation D397 and N397 DNE mice for any measure. Remarkably, the behavioral profiles of second-generation N397 DNE progeny closely resembled DNE-naive D397 mice, suggesting that the N397 variant may protect against the intergenerational transmission of DNE-induced neurodevelopmental disorder-like behaviors.
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Affiliation(s)
- Jordan M Buck
- Institute for Behavioral Genetics, University of Colorado Boulder, 1480 30th Street, Boulder, CO, 80309-0447, USA
- Department of Integrative Physiology, University of Colorado, Boulder, USA
| | - Heidi C O'Neill
- Institute for Behavioral Genetics, University of Colorado Boulder, 1480 30th Street, Boulder, CO, 80309-0447, USA
| | - Jerry A Stitzel
- Institute for Behavioral Genetics, University of Colorado Boulder, 1480 30th Street, Boulder, CO, 80309-0447, USA.
- Department of Integrative Physiology, University of Colorado, Boulder, USA.
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8
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Noda Y, Soeda K, Uchida M, Goto S, Ito T, Kitagaki S, Mamiya T, Yoshimi A, Ozaki N, Mouri A. Multiple nicotinic acetylcholine receptor subtypes regulate social or cognitive behaviors in mice repeatedly administered phencyclidine. Behav Brain Res 2021; 408:113284. [PMID: 33819533 DOI: 10.1016/j.bbr.2021.113284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/21/2021] [Accepted: 03/30/2021] [Indexed: 11/15/2022]
Abstract
Habitual smoking in patients with schizophrenia (SCZ) is considered to improve their own psychoses or to develop a vulnerability to psychological dependence on (-)-nicotine ([-]-NIC) by stimulating nicotinic acetylcholine receptors (nAChRs) in the central nervous system. In the present study, we investigated whether habitual smoking is due to get therapeutic effect or to psychological dependence and which nAChR subunits are associated with them using mice that were repeatedly administered phencyclidine (PCP: 10 mg/kg/day, s.c. for 14 days) as SCZ-like model mice. Mice that were repeatedly administered PCP showed impairments in social or cognitive behaviors; decreased expression of α7 and/or α4 nAChR subunits in the prefrontal cortex (PFC); and increased expression of α7, α4, and β2 nAChR subunits in the nucleus accumbens (NAc). These changes were attenuated by repeated administration of (-)-NIC. The attenuating effects on behavioral impairments were prevented by a selective α7 nAChR antagonist and a selective α4β2 nAChR antagonist. At non- or weak effective dose by themselves, co-administration of (-)-NIC (0.03 mg/kg) and risperidone (0.03 mg/kg) showed synergistic effects on behavioral impairments in PCP-administered mice. Repeated (-)-NIC administration did not affect the performance of conditioned place preference, while it showed behavioral sensitization to (-)-NIC in the PCP-administered mice. Repeated (-)-NIC administration did not affect the performance of conditioned place preference, while it showed behavioral sensitization to (-)-NIC and attenuating effect on haloperidol-induced catalepsy in the PCP-administered mice. Our findings suggest that habitual smoking in SCZ might be attributed to get therapeutic and reduce side effects mediated by α7 and α4β2 nAChR activation by (-)-NIC.
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Affiliation(s)
- Yukihiro Noda
- Division of Clinical Sciences and Neuropsychopharmacology, Meijo University Faculty and Graduate School of Pharmacy, Nagoya, 468-8503, Japan.
| | - Koki Soeda
- Division of Clinical Sciences and Neuropsychopharmacology, Meijo University Faculty and Graduate School of Pharmacy, Nagoya, 468-8503, Japan
| | - Mizuki Uchida
- Division of Clinical Sciences and Neuropsychopharmacology, Meijo University Faculty and Graduate School of Pharmacy, Nagoya, 468-8503, Japan
| | - Sakika Goto
- Division of Clinical Sciences and Neuropsychopharmacology, Meijo University Faculty and Graduate School of Pharmacy, Nagoya, 468-8503, Japan
| | - Takahiro Ito
- Division of Clinical Sciences and Neuropsychopharmacology, Meijo University Faculty and Graduate School of Pharmacy, Nagoya, 468-8503, Japan
| | - Shinji Kitagaki
- Department of Medical Chemistry, Faculty of Pharmacy, Meijo University, Nagoya, 468-8503, Japan
| | - Takayoshi Mamiya
- Department of Chemical Pharmacology, Faculty of Pharmacy, Meijo University, Nagoya, 468-8503, Japan
| | - Akira Yoshimi
- Division of Clinical Sciences and Neuropsychopharmacology, Meijo University Faculty and Graduate School of Pharmacy, Nagoya, 468-8503, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, 466-8560, Japan
| | - Akihiro Mouri
- Department of Regulatory Science for Evaluation & Development of Pharmaceuticals and Devices, Graduate School of Health Science, Fujita Health University, Toyoake, 470-1192, Japan
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9
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Sun XN, Zhou JB, Li N. Poor Oral Health in Patients with Schizophrenia: a Meta-Analysis of Case-Control Studies. Psychiatr Q 2021; 92:135-145. [PMID: 32483766 DOI: 10.1007/s11126-020-09752-3] [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] [Indexed: 11/29/2022]
Abstract
Patients with schizophrenia have high rates of comorbid physical illness, but there has been less attention to dental diseases in these patients. This meta-analysis of case-control studies systematically examined the oral health in patients with schizophrenia. Case-control studies comparing the oral health in patients with schizophrenia and healthy controls were screened and identified. Standardized mean difference (SMD) with its 95% confidence interval (CI) was calculated using RevMan version 5.3. Three case-control studies comprising 306 patients with schizophrenia and 306 healthy controls were included in this meta-analysis. All studies were rated as "high quality". Patients with schizophrenia had significantly higher scores of decayed, missing and filled teeth (SMD = 0.83, 95%CI: 0.57, 1.09, p < 0.001; I2 = 51%), missing teeth (SMD = 0.79, 95%CI: 0.59, 0.98, p < 0.001; I2 = 19%), and decayed teeth (SMD = 0.89, 95%CI: 0.24, 1.54, p = 0.008; I2 = 92%) when compared to healthy controls. Similarly, patients with schizophrenia had significantly lower filled teeth scores (SMD = -0.76, 95%CI: -1.44, -0.09, p = 0.03; I2 = 93%) when compared to healthy controls. This meta-analysis found that patients with schizophrenia were likely to have worse oral health when compared to healthy controls.
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Affiliation(s)
- Xiao-Ni Sun
- Dental Department, Ningbo Yinzhou People's Hospital Community, Zhejiang, 315040, China.
| | - Jian-Bo Zhou
- Dental Department, Ningbo Yinzhou People's Hospital Community, Zhejiang, 315040, China
| | - Na Li
- Dental Department, Ningbo Yinzhou People's Hospital Community, Zhejiang, 315040, China
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10
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Etchecopar-Etchart D, Korchia T, Loundou A, Llorca PM, Auquier P, Lançon C, Boyer L, Fond G. Comorbid Major Depressive Disorder in Schizophrenia: A Systematic Review and Meta-Analysis. Schizophr Bull 2020; 47:298-308. [PMID: 33252130 PMCID: PMC8451068 DOI: 10.1093/schbul/sbaa153] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Comorbid major depressive disorder (MDD) in schizophrenia (SZ; SZ-MDD) has been identified as a major prognostic factor. However, the prevalence and associated factors of SZ-MDD have never been explored in a meta-analysis. All studies assessing the prevalence of SZ-MDD in stabilized outpatients with a standardized scale or with structured interviews were included. The Medline, Web of Science, PsycINFO, and Google Scholar databases were searched. Using random effects models, we calculated the pooled estimate of the prevalence of SZ-MDD. We used meta-regression and subgroup analyses to evaluate the potential moderators of the prevalence estimates, and we used the leave-one-out method for sensitivity analyses. Of the 5633 potentially eligible studies identified, 18 studies (n = 6140 SZ stabilized outpatients) were retrieved in the systematic review and included in the meta-analysis. The pooled estimate of the prevalence of SZ-MDD was 32.6% (95% CI: 27.9-37.6); there was high heterogeneity (I2 = 92.6%), and Egger's test did not reveal publication bias (P = .122). The following factors were found to be sources of heterogeneity: publication in or after 2015, the inclusion of patients from larger studies, the assessment tools, the inclusion of patients with substance use disorder or somatic chronic diseases, age, education level, the lifetime number of hospitalizations, and antidepressant use. Two-thirds of the extracted variables could not be explored due to an insufficient amount of published data. The prevalence of MDD is high among SZ individuals. Healthcare providers and public health officials should have an increased awareness of the burden of SZ-MDD.
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Affiliation(s)
- Damien Etchecopar-Etchart
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, Marseille, France
| | - Theo Korchia
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, Marseille, France
| | - Anderson Loundou
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, Marseille, France
| | | | - Pascal Auquier
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, Marseille, France
| | - Christophe Lançon
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, Marseille, France
| | - Laurent Boyer
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, Marseille, France
| | - Guillaume Fond
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, Marseille, France,To whom correspondence should be addressed; tel: +33668102258, e-mail:
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11
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Long-Acting Injectable Antipsychotics: Analysis of Prescription Patterns and Patient Characteristics in Mental Health from a Spanish Real-World Study. Clin Drug Investig 2020; 40:459-468. [PMID: 32274654 DOI: 10.1007/s40261-020-00913-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVE Long-acting injectable antipsychotics (LAIs) have been widely studied in schizophrenia and evidence suggests that they could be also used for the treatment of bipolar and schizoaffective disorders. Nonetheless, there are no studies evaluating their role in other psychiatric disorders. We aimed to evaluate the use of the newest monthly and 3-monthly LAIs-aripiprazole once monthly, paliperidone 1- and 3-monthly (PP1M, PP3M)-against the 2-weekly LAIs, using the following clinical outcomes: (1) the number of hospital re-admissions, (2) the number of documented suicidal behaviors/attempts, and (3) the use of concomitant treatments, including benzodiazepines, oral antipsychotics, and biperiden. METHODS A total of 431 patients were included who were treated with the corresponding LAI over at least 12 months and were previously diagnosed with a psychiatric disorder. Statistical analyses were performed using an ANCOVA model, Student's t test, and the Pearson's r test. RESULTS Our results showed significantly decreased re-admissions using PP3M versus the bi-weekly LAIs and aripiprazole once monthly, while no significant differences were found in suicidal behavior. Furthermore, we found a significantly lower intake of benzodiazepines in PP1M and PP3M groups versus the bi-weekly and aripiprazole once-monthly groups. In addition, patients treated with PP1M and PP3M used a significantly lower dose of haloperidol equivalents versus the bi-weekly LAIs group. Finally, significantly higher doses of biperiden were used by the bi-weekly LAIs group. CONCLUSION In conclusion, paliperidone LAIs reduced hospital re-admissions and, as aripiprazole once monthly, lowered concomitant psychiatric medication versus the bi-weekly LAIs. Further research and analysis of subgroups are needed; however, these findings might be useful for clinicians.
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12
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Fond G, Godin O, Schürhoff F, Berna F, André M, Aouizerate B, Capdevielle D, Chereau I, D' Amato T, Dubertret C, Dubreucq J, Faget C, Lançon C, Leignier S, Mallet J, Misdrahi D, Passerieux C, Pignon B, Rey R, Szoke A, Urbach M, Vidailhet P, Leboyer M, Boyer L, Llorca PM. Confirmations, advances and recommendations for the daily care of schizophrenia based on the French national FACE-SZ cohort. Prog Neuropsychopharmacol Biol Psychiatry 2020; 101:109927. [PMID: 32173456 DOI: 10.1016/j.pnpbp.2020.109927] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/11/2020] [Accepted: 03/11/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The National FondaMental Centers of Expertise (FACE) for Schizophrenia (SZ) have been created to shorten the gap between research and clinical practice. OBJECTIVES To synthetize in a review the 10-year findings issued from the FACE-SZ cohort analyses. METHODS More than 1000 patients were evaluated in 10 expert centers since 2010 with a 2-day long comprehensive standardized battery including neuropsychological testes and physical health assessment and followed-up for 3 years. RESULTS 1. The phase 0 cross-sectional analyses have confirmed well-known data: over-prescription of first-generation antipsychotics, antipsychotic polytherapy and long-term benzodiazepine and under-prescription of clozapine, 13% of drug-induced parkinsonism, 18% of akathisia, a mean duration of untreated psychosis of 18 months, one third of poorly-adherent patients, 24% of metabolic syndrome and 52% of current tobacco smokers with poor care for physical illnesses; a yearly mean financial cost of 15,000 euro/patient. 2. FACE-SZ also yielded additional data in insufficiently explored area: a half of major depression issues (among them one third of undiagnosed major depression and 44% of treated patients with unremitted depression), major depression having a strong impact on Quality of Life independently of negative symptoms, 22% of moderated to severe untreated physical pain. 3. FACE-SZ has explored emerging fields of research, including development of 4 stages- model of schizophrenia, chronic low-grade peripheral inflammation, latent Toxoplasma infection, hypovitaminosis D, and a model for relapse prediction at 2 years. DISCUSSION The associated factors and implications for public health programs were discussed. Based on the FACE-SZ findings and literature, the FACE-SZ group has yielded recommendations to improve daily care for schizophrenia and for future research.
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Affiliation(s)
- G Fond
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, Marseille 13005, France.
| | - O Godin
- Fondation FondaMental, Créteil, France
| | - F Schürhoff
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - F Berna
- Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - M André
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm, Montpellier 1061, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, Bordeaux F-33076, France; INRA, NutriNeuro, University of Bordeaux, U1286, Bordeaux F-33076, France
| | - D Capdevielle
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm, Montpellier 1061, France
| | - I Chereau
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand Cedex 1 BP 69 63003, France
| | - T D' Amato
- Fondation FondaMental, Créteil, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, Bron Cedex 69678, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, Louis Mourier Hospital, Inserm U894, Colombes, France
| | - J Dubreucq
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - C Faget
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, Marseille 13005, France
| | - C Lançon
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, Marseille 13005, France
| | - S Leignier
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - J Mallet
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, Louis Mourier Hospital, Inserm U894, Colombes, France
| | - D Misdrahi
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, Bordeaux F-33076, France; CNRS, UMR 5287-INCIA, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service de psychiatrie et d'addictologie adulte, Le Chesnay, HANDIReSP, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles EA 4047, France
| | - B Pignon
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - R Rey
- Fondation FondaMental, Créteil, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, Bron Cedex 69678, France
| | - A Szoke
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - M Urbach
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service de psychiatrie et d'addictologie adulte, Le Chesnay, HANDIReSP, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles EA 4047, France
| | - P Vidailhet
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - M Leboyer
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - L Boyer
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, Marseille 13005, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand Cedex 1 BP 69 63003, France
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Dumontaud M, Korchia T, Khouani J, Lancon C, Auquier P, Boyer L, Fond G. Sexual dysfunctions in schizophrenia: Beyond antipsychotics. A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2020; 98:109804. [PMID: 31711954 DOI: 10.1016/j.pnpbp.2019.109804] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/10/2019] [Accepted: 11/05/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Sexual dysfunctions (SD) in schizophrenia are frequent with strong impact on adherence and quality of life. Current recommendations stipulate to switch to prolactin-sparing antipsychotic in case of SD. OBJECTIVES To synthetize in a systematic review data on the SD prevalence and the associated risk factors in schizophrenia (SZ). METHODS Medline, Google Scholar, PsychInfo, and Cochrane were explored, without any year or language restriction. RESULTS Overall, 89 studies and 25,490 participants were included in the present review. SZ subjects aged 18-70 reported high SD frequency [30%-82%] (men [33%- 85%]; women [25%- 85%]). For SZ men erectile dysfunction [31%-95%] was the most frequent SD vs. loss of libido for women [31%-100%]. The following risk factors were associated with increased SD: 1. Illness severity (including psychotic symptomatology, early age at SZ onset, negative symptomatology, and continuous illness course), 2. Depressive symptomatology 3. Antipsychotics (especially first generation antipsychotics, risperidone and antipsychotic polytherapy). Switching to prolactin-sparing antipsychotics has shown effectiveness in some studies (especially aripiprazole). Antidepressants were not found to be associated with SD in SZ subjects. CONCLUSION The prevalence of SD is high in SZ subjects. In addition to the current guidelines, the present review suggests that treating depressive symptoms may be a major intervention to improve SD in SZ subjects. Sociodemographic variables, physical illnesses, metabolic syndrome and peripheral inflammation have been poorly or never explored and should be included in future studies.
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Affiliation(s)
- Marion Dumontaud
- Aix-Marseille Univ, CEReSS-Health Service Research and Quality of Life Center, School of Medicine-La Timone Medical, Marseille, France; Aix-Marseille Univ, APHM, Department of Medical Information and Public Health, Marseille, France
| | - Théo Korchia
- Aix-Marseille Univ, CEReSS-Health Service Research and Quality of Life Center, School of Medicine-La Timone Medical, Marseille, France; Aix-Marseille Univ, APHM, Department of Medical Information and Public Health, Marseille, France
| | - Jérémy Khouani
- Aix-Marseille Univ, CEReSS-Health Service Research and Quality of Life Center, School of Medicine-La Timone Medical, Marseille, France; Aix-Marseille Univ, APHM, Department of Medical Information and Public Health, Marseille, France
| | - Christophe Lancon
- Aix-Marseille Univ, CEReSS-Health Service Research and Quality of Life Center, School of Medicine-La Timone Medical, Marseille, France; Aix-Marseille Univ, APHM, Sainte-Marguerite Hospital, Marseille, France
| | - Pascal Auquier
- Aix-Marseille Univ, CEReSS-Health Service Research and Quality of Life Center, School of Medicine-La Timone Medical, Marseille, France; Aix-Marseille Univ, APHM, Department of Medical Information and Public Health, Marseille, France
| | - Laurent Boyer
- Aix-Marseille Univ, CEReSS-Health Service Research and Quality of Life Center, School of Medicine-La Timone Medical, Marseille, France; Aix-Marseille Univ, APHM, Department of Medical Information and Public Health, Marseille, France
| | - Guillaume Fond
- Aix-Marseille Univ, CEReSS-Health Service Research and Quality of Life Center, School of Medicine-La Timone Medical, Marseille, France; Aix-Marseille Univ, APHM, Department of Medical Information and Public Health, Marseille, France.
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Abstract
Human behavior can be controlled by physical or psychological dependencies associated with addiction. One of the most insidious addictions in our society is the use of tobacco products which contain nicotine. This addiction can be associated with specific receptors in the brain that respond to the natural neurotransmitter acetylcholine. These nicotinic acetylcholine receptors (nAChR) are ligand-gated ion channels formed by the assembly of one or multiple types of nAChR receptor subunits. In this paper, we review the structure and diversity of nAChR subunits and our understanding for how different nAChR subtypes play specific roles in the phenomenon of nicotine addiction. We focus on receptors containing β2 and/or α6 subunits and the special significance of α5-containing receptors. These subtypes all have roles in regulating dopamine-mediated neurotransmission in the mesolimbic reward pathways of the brain. We also discuss the unique roles of homomeric α7 nAChR in behavioral responses to nicotine and how our knowledge of nAChR functional diversity may help guide pharmacotherapeutic approaches for treating nicotine addiction. While nicotine addiction is a truly global problem, the use of areca nut (betel) products is also a serious addiction associated with public health issues across most of South Asia, impacting as many as 600 million people. We discuss how cholinergic receptors of the brain are also involved with areca addiction and the unique challenges for dealing with addiction to this substance.
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Kowal C, Peyre H, Amad A, Pelissolo A, Leboyer M, Schürhoff F, Pignon B. Psychotic, Mood, and Anxiety Disorders and Venous Thromboembolism: A Systematic Review and Meta-Analysis. Psychosom Med 2020; 82:838-849. [PMID: 32947580 DOI: 10.1097/psy.0000000000000863] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Several studies have shown that psychiatric disorders can be associated with venous thromboembolism (VTE) risk, that is, pulmonary embolism (PE) and/or deep vein thrombosis (DVT). In this study, we provide a systematic review and meta-analyses of the studies addressing this issue. METHODS All studies addressing the risk of VTE phenomena (whole VTE, PE, DVT, fatal VTE) in individuals with psychotic, mood, and anxiety disorders published between 1998 and 2019 were reviewed and included in the meta-analyses. Main characteristics of the studies and data concerning VTE risk were extracted. The methodological qualities of the studies were also analyzed. A random-effects meta-analysis model was used. A meta-analysis was conducted separately for each disorder, as well as separately for unadjusted and adjusted studies. Meta-analyses were repeated considering only good-quality studies. Heterogeneity was assessed. RESULTS Sixteen studies were reviewed and 15 included in the meta-analyses. Psychotic and bipolar disorders were significantly associated with VTE risk (VTE, DVT, PE, and fatal VTE for psychotic disorder: odds ratios [ORs] between 1.29 and 2.20; VTE, DVT, and PE for bipolar disorder: ORs between 1.22 and 2.14). Depression and anxiety disorders were associated with VTE risk only in adjusted analyses (DVT and PE for depression: ORs = 1.29; VTE and PE for anxiety disorders: ORs between 1.14 and 1.49). CONCLUSIONS The risk of VTE among individuals with psychiatric disorders may be explained by hypercoagulability and stasis, with both being related to, and independent of, treatment adverse effects. VTE risk should be taken into consideration in the treatment for people with psychiatric disorders.
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Affiliation(s)
- Célia Kowal
- From the AP-HP, GH Henri Mondor (Kowal), Service de pharmacie, Créteil; AP-HP, Hôpital universitaire Robert Debré (Peyre), Service de pédopsychiatrie, Paris; AP-HP, DMU IMPACT, GH Henri Mondor (Pelissolo, Leboyer, Schürhoff, Pignon), Service de Psychiatrie; Inserm, U955, team 15 (Pelissolo, Leboyer, Schürhoff, Pignon); Fondation FondaMental (Pelissolo, Leboyer, Schürhoff, Pignon); UPEC, Université Paris-Est Créteil Faculté de médecine (Pelissolo, Leboyer, Schürhoff, Pignon), Créteil; Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, and CHU Lille (Amad), Pôle de Psychiatrie, Unité CURE; Fédération régionale de recherche en santé mentale (F2RSM) Hauts-de-France (Amad), Lille, France; and Institute of Psychiatry, Psychology and Neuroscience (Amad), College London, London, United Kingdom
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Whitton AE, Green AI, Pizzagalli DA, Roth RM, Williams JM, Brunette MF. Potent Dopamine D2 Antagonists Block the Reward-Enhancing Effects of Nicotine in Smokers With Schizophrenia. Schizophr Bull 2019; 45:1300-1308. [PMID: 30690638 PMCID: PMC6811816 DOI: 10.1093/schbul/sby185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Antipsychotics that are potent dopamine (DA) D2 receptor antagonists have been linked to elevated levels of nicotine dependence in smokers with schizophrenia. Because activation of D2 receptors mediates motivation for nicotine, we examined whether potent D2 antagonists would diminish nicotine's ability to stimulate reward processing-a mechanism that may drive compensatory increases in smoking. Smokers with schizophrenia (n = 184) were recruited and stratified into medication groups based on D2 receptor antagonist potency. The effects of smoking on reward function were assessed using a probabilistic reward task (PRT), administered pre- and post-smoking. The PRT used an asymmetrical reinforcement schedule to produce a behavioral response bias, previously found to increase under conditions (including smoking) that enhance mesolimbic DA signaling. Among the 98 participants with valid PRT data and pharmacotherapy that could be stratified into D2 receptor antagonism potency, a medication × smoking × block interaction emerged (P = .005). Post-hoc tests revealed a smoking × block interaction only for those not taking potent D2 antagonists (P = .007). This group exhibited smoking-related increases in response bias (P < .001) that were absent in those taking potent D2 antagonists (P > .05). Our findings suggest that potent D2 antagonists diminish the reward-enhancing effects of nicotine in smokers with schizophrenia. This may be a mechanism implicated in the increased rate of smoking often observed in patients prescribed these medications. These findings have important clinical implications for the treatment of nicotine dependence in schizophrenia.
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Affiliation(s)
- Alexis E Whitton
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Alan I Green
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH,Dartmouth Clinical and Translational Science Institute, Hanover, NH
| | - Diego A Pizzagalli
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Robert M Roth
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Jill M Williams
- Department of Psychiatry, Rutgers University, New Brunswick, NJ
| | - Mary F Brunette
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH,To whom correspondence should be addressed; Department of Psychiatry, Dartmouth-Hitchcock, 2 Pillsbury Street, Suite 40, Concord, NH 03301, US; tel: 603-229-5419, fax: 603-271-5262, e-mail:
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Abstract
PURPOSE OF REVIEW Recent epidemiology, biological and clinical findings correlate high cigarette consumption in patients with schizophrenia, impeding both treatment strategies and the effectiveness of antipsychotics. RECENT FINDINGS New data suggests that despite world-wide efforts to curb cigarette consumption, smoking in patients with schizophrenia was still high. Recent reports could not confirm earlier findings regarding smoking's beneficial effects on cognitive dysfunction, however, the association between smoking, positive symptoms and suicidal behavior was revealed. As some patients smoked in an attempt to alleviate extrapyramidal symptoms (EPS) and negative symptoms, the molecular studies shared genetic roots correlating smoking and schizophrenia, revealing that smoking may increase the risk of developing schizophrenia. Preclinical and clinical studies clarified the complex relationship between schizophrenia's pathology and nicotine's effects on the human brain. SUMMARY Cigarette smoking continues to adversely affect the health of individuals with schizophrenia. Both smoking and heavy nicotine dependence, given the complex biological findings, might influence symptom severity in patients with schizophrenia. Regardless, ceasing smoking activities is strongly advocated to replace 'self-medication by nicotine' with safer and more effective medications.
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18
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Abstract
PURPOSE OF REVIEW Previous research has demonstrated the high prevalence of medical comorbidity and multimorbidity among patients with schizophrenia. However, little is known regarding the potential effects of chronic physical illness (CPI) on schizophrenia treatment outcomes. In the present report, we aim to provide an updated review of the relevant literature. RECENT FINDINGS We searched MEDLINE for studies published between 2017 and 2018. After screening 683 articles, we included six studies of adequate quality. Five of these studies reported significant associations between several CPIs and different schizophrenia treatment outcomes, whereas the remaining study did not. Significant effects were low to moderate in size. CPIs with significant effects on treatment outcomes included metabolic syndrome, cardiovascular disease, and asthma. No significant effects were observed for diabetes, chronic obstructive pulmonary disease, hepatitis, hypertension, hyperlipidemia, or lung conditions. One study reported a significant association between the total number of CPIs and the overall number of psychiatric rehospitalizations. SUMMARY In addition to increasing the risk of premature mortality, accumulating evidence indicates that various CPIs affect schizophrenia treatment outcomes. Thus, researchers and healthcare practitioners should increase efforts to raise awareness regarding the importance of physical health among patients with schizophrenia. Further high-quality studies are required, particularly those targeting the potential effects of individual CPIs.
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19
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Bourbon A, Boyer L, Auquier P, Boucekine M, Barrow V, Lançon C, Fond G. Anxiolytic consumption is associated with tobacco smoking and severe nicotine dependence. Results from the national French medical students (BOURBON) study. Prog Neuropsychopharmacol Biol Psychiatry 2019; 94:109645. [PMID: 31082413 DOI: 10.1016/j.pnpbp.2019.109645] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 04/28/2019] [Accepted: 05/06/2019] [Indexed: 10/26/2022]
Abstract
UNLABELLED Tobacco smoking remains common among medical students, something which may impact on their abililty to promote smoking cessation during their future careers. OBJECTIVES To determine the prevalence of smoking and consumption among French medical students and explore the link between both the presence of psychosocial factors and consumption of psychotropic medication and the severity of nicotine dependence and daily smoking behavior. METHODS Medical students were recruited from 35 French universities of medicine through administration mailing lists and social networks, between December 13, 2016 and May 15, 2017. Data was collected via anonymized Internet questionnaire which included questions regarding current daily tobacco smoking behaviors. Severe nicotine dependence was defined by a short Fagerström test equal or >4. RESULTS 10,985 medical students with a mean aged of 21.8 years (+/-3.3) were included, 31.6% of which were male. 2078 (18.9%) were identified as current daily tobacco smokers and 59 (2.8%) were classed as having severe nicotine dependence. In multivariate analyses, tobacco smoking was independently associated with anxiolytic consumption, alcohol use disorder, cannabis use disorder, financial difficulties, and history of sexual and physical assault. Severe nicotine dependence was independently associated with anxiolytic consumption, cannabis use disorder, domestic violence, physical assault and financial difficulties. CONCLUSION Tobacco smoking has been found in almost one on 5 medical students and is associated with anxiolytic consumption as well as professional and personal factors.
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Affiliation(s)
- A Bourbon
- Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS - Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - L Boyer
- Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS - Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - P Auquier
- Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS - Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - M Boucekine
- Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS - Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - V Barrow
- Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS - Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - C Lançon
- Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS - Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - G Fond
- Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS - Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France.
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20
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Fond G, Bulzacka E, Boucekine M, Schürhoff F, Berna F, Godin O, Aouizerate B, Capdevielle D, Chereau I, D'Amato T, Dubertret C, Dubreucq J, Faget C, Leignier S, Lançon C, Mallet J, Misdrahi D, Passerieux C, Rey R, Schandrin A, Urbach M, Vidailhet P, Leboyer M, Boyer L, Llorca PM. Machine learning for predicting psychotic relapse at 2 years in schizophrenia in the national FACE-SZ cohort. Prog Neuropsychopharmacol Biol Psychiatry 2019; 92:8-18. [PMID: 30552914 DOI: 10.1016/j.pnpbp.2018.12.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 11/27/2018] [Accepted: 12/10/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Predicting psychotic relapse is one of the major challenges in the daily care of schizophrenia. OBJECTIVES To determine the predictors of psychotic relapse and follow-up withdrawal in a non-selected national sample of stabilized community-dwelling SZ subjects with a machine learning approach. METHODS Participants were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia and received a thorough clinical and cognitive assessment, including recording of current treatment. Relapse was defined by at least one acute psychotic episode of at least 7 days, reported by the patient, her/his relatives or by the treating psychiatrist, within the 2-year follow-up. A classification and regression tree (CART) was used to construct a predictive decision tree of relapse and follow-up withdrawal. RESULTS Overall, 549 patients were evaluated in the expert centers at baseline and 315 (57.4%) (mean age = 32.6 years, 24% female gender) were followed-up at 2 years. On the 315 patients who received a visit at 2 years, 125(39.7%) patients had experienced psychotic relapse at least once within the 2 years of follow-up. High anger (Buss&Perry subscore), high physical aggressiveness (Buss&Perry scale subscore), high lifetime number of hospitalization in psychiatry, low education level, and high positive symptomatology at baseline (PANSS positive subscore) were found to be the best predictors of relapse at 2 years, with a percentage of correct prediction of 63.8%, sensitivity 71.0% and specificity 44.8%. High PANSS excited score, illness duration <2 years, low Buss&Perry hostility score, high CTQ score, low premorbid IQ and low medication adherence (BARS) score were found to be the best predictors of follow-up withdrawal with a percentage of correct prediction of 52.4%, sensitivity 62%, specificity 38.7%. CONCLUSION Machine learning can help constructing predictive score. In the present sample, aggressiveness appears to be a good early warning sign of psychotic relapse and follow-up withdrawal and should be systematically assessed in SZ subjects. The other above-mentioned clinical variables may help clinicians to improve the prediction of psychotic relapse at 2 years.
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Affiliation(s)
- G Fond
- Fondation FondaMental, Créteil, France; Faculté de Médecine - Secteur Timone, Aix-Marseille Univ, d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France.
| | - E Bulzacka
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - M Boucekine
- Faculté de Médecine - Secteur Timone, Aix-Marseille Univ, d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - F Schürhoff
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - F Berna
- Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - O Godin
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, Bordeaux F-33076, France; INRA, NutriNeuro, University of Bordeaux, U1286, Bordeaux F-33076, France
| | - D Capdevielle
- Fondation FondaMental, Créteil, France; Hôpital la Colombière, CHRU Montpellier, Service Universitaire de Psychiatrie Adulte, Université Montpellier 1, Montpellier 1061, France
| | - I Chereau
- Fondation FondaMental, Créteil, France; Faculté de Médecine, Université d'Auvergne, CMP B, CHU, EA 7280, Clermont-Ferrand Cedex 69 63003, France
| | - T D'Amato
- Fondation FondaMental, Créteil, France; Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, Bron Cedex 69678, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Faculté de médecine, Louis Mourier Hospital, Université Paris Diderot, Colombes U894, France
| | - J Dubreucq
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, Alpes Isère, Grenoble, France
| | - C Faget
- Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - S Leignier
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, Alpes Isère, Grenoble, France
| | - C Lançon
- Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - J Mallet
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Faculté de médecine, Louis Mourier Hospital, Université Paris Diderot, Colombes U894, France
| | - D Misdrahi
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, Bordeaux F-33076, France; CNRS UMR 5287-INCIA, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France; Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - R Rey
- Fondation FondaMental, Créteil, France; Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, Bron Cedex 69678, France
| | - A Schandrin
- Fondation FondaMental, Créteil, France; Hôpital la Colombière, CHRU Montpellier, Service Universitaire de Psychiatrie Adulte, Université Montpellier 1, Montpellier 1061, France
| | - M Urbach
- Fondation FondaMental, Créteil, France; Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - P Vidailhet
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - M Leboyer
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | | | - L Boyer
- Fondation FondaMental, Créteil, France; Faculté de Médecine - Secteur Timone, Aix-Marseille Univ, d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France; Faculté de Médecine, Université d'Auvergne, CMP B, CHU, EA 7280, Clermont-Ferrand Cedex 69 63003, France
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Mallet J, Le Strat Y, Schürhoff F, Mazer N, Portalier C, Andrianarisoa M, Aouizerate B, Berna F, Brunel L, Capdevielle D, Chereau I, D'Amato T, Dubreucq J, Faget C, Gabayet F, Honciuc RM, Lançon C, Llorca PM, Misdrahi D, Rey R, Roux P, Schandrin A, Urbach M, Vidailhet P, Fond G, Dubertret C. Tobacco smoking is associated with antipsychotic medication, physical aggressiveness, and alcohol use disorder in schizophrenia: results from the FACE-SZ national cohort. Eur Arch Psychiatry Clin Neurosci 2019; 269:449-457. [PMID: 29396753 DOI: 10.1007/s00406-018-0873-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 01/24/2018] [Indexed: 12/31/2022]
Abstract
Tobacco smoking is common in schizophrenia and is one of the main causes of premature mortality in this disorder. Little is known about clinical correlates and treatments associated with tobacco smoking in patients with schizophrenia. Still, a better characterization of these patients is necessary, in a personalized care approach. Aggressiveness and childhood trauma have been associated with tobacco smoking in general population, but this association has never been explored in schizophrenia. Our study examines the clinical and therapeutic characteristics of tobacco smoking in schizophrenia. 474 stabilized patients (mean age = 32.2; 75.7% male gender; smokers n = 207, 54.6%) were consecutively included in the network of the FondaMental Expert centers for Schizophrenia and assessed with valid scales. Current tobacco status was self-declared. Aggressiveness was self-reported with Buss-Perry Aggressiveness Questionnaire and Childhood Trauma with Childhood Trauma Questionnaire. Ongoing treatment was reported. In univariate analysis, tobacco smoking was associated with lower education level (p < 0.01), positive syndrome (p < 0.01), higher physical aggressiveness (p < 0.001), alcohol dependence (p < 0.001), and First Generation Antipsychotics (FGAs) use (p = 0.018). In a multivariate model, tobacco smoking remained associated with physical aggressiveness (p < 0.05), current alcohol dependence (p < 0.01) and FGA use (p < 0.05). No association was observed with childhood trauma history, mood disorder, suicidal behavior, psychotic symptom, global functioning or medication adherence. Patients with tobacco use present clinical and therapeutic specificities, questioning the neurobiological links between tobacco and schizophrenia. They could represent a specific phenotype, with specific clinical and therapeutic specificities that may involve interactions between cholinergic-nicotinic system and dopaminergic system. Further longitudinal studies are needed to confirm the potential efficacy of second generation antipsychotics (SGAs) on tobacco use in schizophrenia and to develop effective strategies for tobacco cessation in this population.
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Affiliation(s)
- J Mallet
- Fondation FondaMental, Créteil, France. .,AP-HP, Paris, France. .,Department of Psychiatry, Service de Psychiatrie et d'Addictologie, Hôpital Louis Mourier, 178 rue des Renouillers, 92700, Colombes, France. .,Inserm U894, Paris, France. .,Sorbonne Paris Cité, Faculté de Médecine, Université Paris Diderot, Paris, France.
| | - Y Le Strat
- Fondation FondaMental, Créteil, France.,AP-HP, Paris, France.,Department of Psychiatry, Service de Psychiatrie et d'Addictologie, Hôpital Louis Mourier, 178 rue des Renouillers, 92700, Colombes, France.,Inserm U894, Paris, France.,Sorbonne Paris Cité, Faculté de Médecine, Université Paris Diderot, Paris, France
| | - F Schürhoff
- Fondation FondaMental, Créteil, France.,INSERM U955, Équipe de Psychiatrie Translationnelle, Créteil, France.,Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - N Mazer
- Fondation FondaMental, Créteil, France.,AP-HP, Paris, France.,Department of Psychiatry, Service de Psychiatrie et d'Addictologie, Hôpital Louis Mourier, 178 rue des Renouillers, 92700, Colombes, France.,Inserm U894, Paris, France.,Sorbonne Paris Cité, Faculté de Médecine, Université Paris Diderot, Paris, France
| | - C Portalier
- Fondation FondaMental, Créteil, France.,AP-HP, Paris, France.,Department of Psychiatry, Service de Psychiatrie et d'Addictologie, Hôpital Louis Mourier, 178 rue des Renouillers, 92700, Colombes, France.,Inserm U894, Paris, France.,Sorbonne Paris Cité, Faculté de Médecine, Université Paris Diderot, Paris, France
| | - M Andrianarisoa
- Fondation FondaMental, Créteil, France.,INSERM U955, Équipe de Psychiatrie Translationnelle, Créteil, France.,Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France.,Centre Hospitalier Charles Perrens, 33076, Bordeaux, France.,Université de Bordeaux, Bordeaux, France.,Bordeaux Sleep Clinique, Pellegrin University Hospital, Bordeaux University, USR CNRS 3413 SANPSY, Research Unit, 33000, Bordeaux, France.,Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, 33000, Bordeaux, France
| | - F Berna
- Fondation FondaMental, Créteil, France.,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - L Brunel
- Fondation FondaMental, Créteil, France.,INSERM U955, Équipe de Psychiatrie Translationnelle, Créteil, France.,Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - D Capdevielle
- Fondation FondaMental, Créteil, France.,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - I Chereau
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - T D'Amato
- Fondation FondaMental, Créteil, France.,INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678, Bron Cedex, France
| | - J Dubreucq
- Fondation FondaMental, Créteil, France.,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - C Faget
- Fondation FondaMental, Créteil, France.,Pôle Psychiatrie Universitaire, CHU Sainte-Marguerite, 13274, Marseille Cedex 09, France
| | - F Gabayet
- Fondation FondaMental, Créteil, France.,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - R M Honciuc
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - C Lançon
- Fondation FondaMental, Créteil, France.,Assistance Publique des Hôpitaux de Marseille (AP-HM), Pôle Universitaire de Psychiatrie, Marseille, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - D Misdrahi
- Fondation FondaMental, Créteil, France.,Centre Hospitalier Charles Perrens, 33076, Bordeaux, France.,Université de Bordeaux, Bordeaux, France.,CNRS UMR 5287-INCIA, Bordeaux, France
| | - R Rey
- Fondation FondaMental, Créteil, France.,INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678, Bron Cedex, France
| | - P Roux
- Fondation FondaMental, Créteil, France.,Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - A Schandrin
- Fondation FondaMental, Créteil, France.,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - M Urbach
- Fondation FondaMental, Créteil, France.,Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - P Vidailhet
- Fondation FondaMental, Créteil, France.,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - G Fond
- Fondation FondaMental, Créteil, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France.,AP-HP, Paris, France.,Department of Psychiatry, Service de Psychiatrie et d'Addictologie, Hôpital Louis Mourier, 178 rue des Renouillers, 92700, Colombes, France.,Inserm U894, Paris, France.,Sorbonne Paris Cité, Faculté de Médecine, Université Paris Diderot, Paris, France
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Oral health in schizophrenia patients: A French Multicenter Cross-Sectional Study. Presse Med 2019; 48:e89-e99. [DOI: 10.1016/j.lpm.2018.06.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 05/12/2018] [Accepted: 06/21/2018] [Indexed: 11/18/2022] Open
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23
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Schürhoff F, Fond G, Berna F, Bulzacka E, Godin O, Boyer L, Misdrahi D, Andrianarisoa M, Brunel L, Coulon N, Aouizerate B, Capdevielle D, Chereau I, D'Amato T, Dubertret C, Dubreucq J, Faget C, Gabayet F, Mallet J, Rey R, Lancon C, Passerieux C, Schandrin A, Urbach M, Vidailhet P, Leboyer M, Llorca PM. [The 10-year findings from the FondaMental Academic Center of Expertise for Schizophrenia (FACE-SZ): Review and recommendations for clinical practice]. Encephale 2018; 45:9-14. [PMID: 30327207 DOI: 10.1016/j.encep.2018.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 07/25/2018] [Accepted: 07/27/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The present article is a synthesis of the first 10 years of follow-up of the FondaMental Academic Center of Expertise for Schizophrenia (FACE-SZ) cohort. METHODS More than 700 community-dwelling stabilized subjects have been recruited and evaluated to date. The mean age was 32 years with 75 % males, the mean illness duration was 11 years, the mean age at illness onset was 21 years, the mean duration of untreated psychosis was 1.5 years and 55 % were current daily tobacco smokers. RESULTS The major findings of the FACE-SZ cohort may be summarized as follows: the metabolic syndrome is twice more frequent in schizophrenia as compared to the general population and is not correctly assessed and treated; cognitive disturbances have been found in benzodiazepine consumers and in patients with chronic low-grade peripheral inflammation; major depressive disorder (MDD) is a common current comorbid condition in about 20% of the subjects at the evaluation. MDD is associated with impaired quality of life and with increased nicotine dependency in SZ daily tobacco smokers. Improving depression and negative symptoms may be the most effective strategies to improve quality of life in schizophrenia; the duration of untreated psychosis is much longer in cannabis smokers and in subjects with an age at illness onset<19 years. Adherence to treatment is diminished in subjects who report a subjective negative feeling after treatment intake independent of objective side effects (extrapyramidal syndrome and weight gain). Akathisia has been found in 18% of the subjects and has been associated with antipsychotic polytherapy. CONCLUSIONS In the light of these results, some recommendations for clinical care may be suggested. The early detection of schizophrenia should be specifically increased in adolescents and/or cannabis smokers. All patients should be administered a comprehensive neuropsychological evaluation at the beginning of the illness and after stabilization under treatment. Improving metabolic parameters and lifestyle (diet and physical activity) should be reinforced. The benefit/risk ratio of benzodiazepine and antipsychotic polytherapy should be regularly reevaluated and withdrawn as soon as possible. If MDD remains underdiagnosed and undertreated, improving depression may strongly improve the quality of life of SZ subjects. In the end, Cognitive Remediation Therapy and anti-inflammatory strategies should be more frequently included in therapeutic strategies.
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Affiliation(s)
- F Schürhoff
- Fondation FondaMental, 94000 Créteil, France; Inserm U955, translational psychiatry team, 94000 Créteil, France; Pôle de psychiatrie des hôpitaux universitaires Henri-Mondor, DHU Pe-PSY, Paris Est University, 94000 Créteil, France.
| | - G Fond
- Fondation FondaMental, 94000 Créteil, France
| | - F Berna
- Fondation FondaMental, 94000 Créteil, France; Inserm U1114, fédération de médecine translationnelle de Strasbourg, hôpitaux universitaires de Strasbourg, université de Strasbourg, 67000 Strasbourg, France
| | - E Bulzacka
- Fondation FondaMental, 94000 Créteil, France; Inserm U955, translational psychiatry team, 94000 Créteil, France; Pôle de psychiatrie des hôpitaux universitaires Henri-Mondor, DHU Pe-PSY, Paris Est University, 94000 Créteil, France
| | - O Godin
- Fondation FondaMental, 94000 Créteil, France; UMR_S 1136, institut Pierre Louis d'épidémiologie et de santé publique, Sorbonne universités, UPMC université Paris 06, 75013 Paris, France
| | - L Boyer
- Fondation FondaMental, 94000 Créteil, France; Pôle psychiatrie universitaire, CHU Sainte-Marguerite, 13274 Marseille cedex 09, France
| | - D Misdrahi
- Fondation FondaMental, 94000 Créteil, France; Université de Bordeaux, centre hospitalier Charles Perrens, 33076 Bordeaux, France; CNRS UMR 5287-INCIA, 33000 Bordeaux, France
| | - M Andrianarisoa
- Fondation FondaMental, 94000 Créteil, France; Inserm U955, translational psychiatry team, 94000 Créteil, France; Pôle de psychiatrie des hôpitaux universitaires Henri-Mondor, DHU Pe-PSY, Paris Est University, 94000 Créteil, France
| | - L Brunel
- Fondation FondaMental, 94000 Créteil, France; Inserm U955, translational psychiatry team, 94000 Créteil, France; Pôle de psychiatrie des hôpitaux universitaires Henri-Mondor, DHU Pe-PSY, Paris Est University, 94000 Créteil, France
| | - N Coulon
- Fondation FondaMental, 94000 Créteil, France; Inserm U955, translational psychiatry team, 94000 Créteil, France; Pôle de psychiatrie des hôpitaux universitaires Henri-Mondor, DHU Pe-PSY, Paris Est University, 94000 Créteil, France
| | - B Aouizerate
- Fondation FondaMental, 94000 Créteil, France; Université de Bordeaux, centre hospitalier Charles Perrens, 33076 Bordeaux, France; Inserm, neurocentre Magendie, physiopathologie de la plasticité neuronale, U862, 33000 Bordeaux, France
| | - D Capdevielle
- Fondation FondaMental, 94000 Créteil, France; Inserm 1061, service universitaire de psychiatrie adulte, hôpital la Colombière, université Montpellier 1, CHRU Montpellier, 34090 Montpellier, France
| | - I Chereau
- Fondation FondaMental, 94000 Créteil, France; EA 7280 faculté de médecine, université d'Auvergne, CHU, CMP B, BP 69, 63003 Clermont-Ferrand cedex 1, France
| | - T D'Amato
- Fondation FondaMental, 94000 Créteil, France; Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est, BP 300, 39-95 boulevard Pinel, 69678 Bron cedex, France
| | - C Dubertret
- Fondation FondaMental, 94000 Créteil, France; Inserm U894, department of psychiatry, faculté de médecine Louis Mourier, hospital, université Paris Diderot, Sorbonne Paris Cité, AP-HP, 92700 Colombes, France
| | - J Dubreucq
- Fondation FondaMental, 94000 Créteil, France; Centre référent de réhabilitation psychosociale, centre hospitalier Alpes Isère, 38100 Grenoble, France
| | - C Faget
- Fondation FondaMental, 94000 Créteil, France; Pôle universitaire de psychiatrie, Assistance publique des Hôpitaux de Marseille (AP-HM), 13009 Marseille, France
| | - F Gabayet
- Fondation FondaMental, 94000 Créteil, France; Centre référent de réhabilitation psychosociale, centre hospitalier Alpes Isère, 38100 Grenoble, France
| | - J Mallet
- Fondation FondaMental, 94000 Créteil, France; Inserm U894, department of psychiatry, faculté de médecine Louis Mourier, hospital, université Paris Diderot, Sorbonne Paris Cité, AP-HP, 92700 Colombes, France
| | - R Rey
- Fondation FondaMental, 94000 Créteil, France; Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est, BP 300, 39-95 boulevard Pinel, 69678 Bron cedex, France
| | - C Lancon
- Fondation FondaMental, 94000 Créteil, France; Pôle universitaire de psychiatrie, Assistance publique des Hôpitaux de Marseille (AP-HM), 13009 Marseille, France
| | - C Passerieux
- Fondation FondaMental, 94000 Créteil, France; Service de psychiatrie d'adulte, centre hospitalier de Versailles, UFR des sciences de la santé Simone Veil, université Versailles Saint-Quentin en Yvelines, 78000 Versailles, France
| | - A Schandrin
- Fondation FondaMental, 94000 Créteil, France; Inserm 1061, service universitaire de psychiatrie adulte, hôpital la Colombière, université Montpellier 1, CHRU Montpellier, 34090 Montpellier, France
| | - M Urbach
- Fondation FondaMental, 94000 Créteil, France; Service de psychiatrie d'adulte, centre hospitalier de Versailles, UFR des sciences de la santé Simone Veil, université Versailles Saint-Quentin en Yvelines, 78000 Versailles, France
| | - P Vidailhet
- Fondation FondaMental, 94000 Créteil, France; Inserm U1114, fédération de médecine translationnelle de Strasbourg, hôpitaux universitaires de Strasbourg, université de Strasbourg, 67000 Strasbourg, France
| | - M Leboyer
- Fondation FondaMental, 94000 Créteil, France; Inserm U955, translational psychiatry team, 94000 Créteil, France; Pôle de psychiatrie des hôpitaux universitaires Henri-Mondor, DHU Pe-PSY, Paris Est University, 94000 Créteil, France
| | - P M Llorca
- Fondation FondaMental, 94000 Créteil, France; EA 7280 faculté de médecine, université d'Auvergne, CHU, CMP B, BP 69, 63003 Clermont-Ferrand cedex 1, France
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Hidese S, Matsuo J, Ishida I, Hiraishi M, Teraishi T, Ota M, Hattori K, Kunugi H. Association between lower estimated premorbid intelligence quotient and smoking behavior in patients with schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2018; 15:7-13. [PMID: 30310770 PMCID: PMC6176847 DOI: 10.1016/j.scog.2018.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 09/26/2018] [Accepted: 09/30/2018] [Indexed: 12/18/2022]
Abstract
Aim We aimed to investigate the involvement of premorbid intelligence quotient in higher prevalence of smoking in patients with schizophrenia. Methods Participants included 190 patients with schizophrenia (mean ± standard deviation age: 37.7 ± 10.8 years; 88 males and 102 females) and 312 healthy individuals (mean ± standard deviation age: 38.1 ± 13.8; 166 males and 146 females), matched for age, sex, and ethnicity (Japanese). Premorbid intelligence quotient was estimated using the Japanese Adult Reading Test and distress symptoms were assessed using the Hopkins Symptom Check List. Current smoking information was collected according to self-declarations. Results As expected, the smoking rate was higher, while mean education level and Japanese Adult Reading Test scores were significantly lower, in patients with schizophrenia than in healthy individuals (p < 0.01). The mean education level and Japanese Adult Reading Test scores were significantly lower in the smoker group than in the non-smoker group in both patients and healthy individuals (p < 0.05). In the patient group alone, Hopkins Symptom Check List subscale and total scores were significantly higher in the smoker group than in the non-smoker group (p < 0.05). A multivariate regression analysis showed that the Japanese Adult Reading Test score was a significant and negative predictor for smoking (p < 0.001, odds ratio = 0.97; 95% confidence interval: 0.96–0.99). Conclusion Our results suggest that lower estimated premorbid intelligence quotient is an important variable in elucidating smoking behavior in humans and may be associated with higher prevalence of smoking in patients with schizophrenia. Lower premorbid intelligence quotient (IQ) was observed in patients with schizophrenia who were smokers. Lower education level was observed in patients with schizophrenia who were smokers. Lower premorbid IQ and education level were also seen in smokers in the healthy group. Distress symptoms were higher in smokers with schizophrenia. In total, premorbid IQ was a negative predictor for smoking.
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Key Words
- ANCOVA, Analysis of covariance
- CI, Confidence interval
- Distress symptom
- Education level
- HSCL, Hopkins Symptom Check List
- IQ, Intelligence quotient
- JART, Japanese Adult Reading Test
- MANCOVA, Multivariate analysis of covariance
- NART, National Adult Reading Test
- OR, Odds ratio
- PANSS, Positive and Negative Syndrome Scale
- PSQI, Pittsburgh Sleep Quality Index
- Premorbid intelligence quotient
- Schizophrenia
- Smoking
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Affiliation(s)
- Shinsuke Hidese
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Junko Matsuo
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Ikki Ishida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Moeko Hiraishi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Toshiya Teraishi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Miho Ota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Kotaro Hattori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
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25
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Fond G, Boyer L, Leboyer M, Godin O, Llorca PM, Andrianarisoa M, Berna F, Brunel L, Aouizerate B, Capdevielle D, Chereau I, D'Amato T, Dubertret C, Dubreucq J, Faget C, Gabayet F, Mallet J, Misdrahi D, Rey R, Lancon C, Passerieux C, Roux P, Vidailhet P, Yazbek H, Schürhoff F, Bulzacka E, Aouizerate B, Berna F, Blanc O, Brunel L, Bulzacka E, Capdevielle D, Chereau-Boudet I, Chesnoy-Servanin G, Danion J, D'Amato T, Deloge A, Delorme C, Denizot H, Dorey J, Dubertret C, Dubreucq J, Faget C, Fluttaz C, Fond G, Fonteneau S, Gabayet F, Giraud-Baro E, Hardy-Bayle M, Lacelle D, Lançon C, Laouamri H, Leboyer M, Le Gloahec T, Le Strat Y, Llorca, Mallet J, Metairie E, Misdrahi D, Offerlin-Meyer I, Passerieux C, Peri P, Pires S, Portalier C, Rey R, Roman C, Sebilleau M, Schandrin A, Schurhoff F, Tessier A, Tronche A, Urbach M, Vaillant F, Vehier A, Vidailhet P, Vilà E, Yazbek H, Zinetti-Bertschy A. Influence of Venus and Mars in the cognitive sky of schizophrenia. Results from the first-step national FACE-SZ cohort. Schizophr Res 2018; 195:357-365. [PMID: 28974404 DOI: 10.1016/j.schres.2017.09.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 09/20/2017] [Accepted: 09/21/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Sex differences can yield important clues regarding illness pathophysiology and its treatment. Schizophrenia (SZ) has a lower incidence rate, and a better prognosis, in women versus men. The present study investigated the cognitive profiles of both sexes in a large multi-centre sample of community-dwelling SZ patients. METHOD 544 community-dwelling stable SZ subjects (141 women and 403 men; mean age 34.5±12.1 and 31.6±8.7years, respectively) were tested with a comprehensive battery of neuropsychological tests. RESULTS Although community-dwelling SZ men had more risk factors for impaired cognition (including first-generation antipsychotics administration and comorbid addictive disorders), women had lower scores on a wide range of cognitive functions, including current and premorbid intellectual functioning, working memory, semantic memory, non-verbal abstract thinking and aspects of visual exploration. However, women scored higher in tests of processing speed and verbal learning, as well as having a lower verbal learning bias. No sex difference were evident for visuospatial learning abilities, cued verbal recall, sustained attention and tests of executive functions, including cognitive flexibility, verbal abstract thinking, verbal fluency and planning abilities. CONCLUSION Sex differences are evident in the cognitive profiles of SZ patients. The impact on daily functioning and prognosis, as well as longitudinal trajectory, should be further investigated in the FACE-SZ follow-up study. Sex differences in cognition have implications for precision-medicine determined therapeutic strategies. LIMITS Given the restricted age range of the sample, future research will have to determine cognitive profiles across gender in late onset SZ.
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Affiliation(s)
- G Fond
- Fondation FondaMental, Créteil, France.
| | - L Boyer
- Fondation FondaMental, Créteil, France; Pôle Psychiatrie Universitaire, CHU Sainte-Marguerite, F-13274 Marseille cedex 09, France
| | - M Leboyer
- Fondation FondaMental, Créteil, France; INSERM U955, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France; Translational Psychiatry Team, Créteil, France
| | - O Godin
- Fondation FondaMental, Créteil, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013 Paris, France; INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013 Paris, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - M Andrianarisoa
- Fondation FondaMental, Créteil, France; INSERM U955, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France; Translational Psychiatry Team, Créteil, France
| | - F Berna
- Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - L Brunel
- Fondation FondaMental, Créteil, France; INSERM U955, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France; Translational Psychiatry Team, Créteil, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, F-33076 Bordeaux, France; Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, F-33000 Bordeaux, France
| | - D Capdevielle
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm, 1061, Montpellier, France
| | - I Chereau
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - T D'Amato
- Fondation FondaMental, Créteil, France; Université Claude Bernard Lyon 1, Centre Hospitalier Le Vinatier, Pole Est BP 300 39 - 95 bd Pinel, 69678 Bron Cedex, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine, France
| | - J Dubreucq
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - C Faget
- Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), Pôle Universitaire de Psychiatrie, Marseille, France
| | - F Gabayet
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - J Mallet
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine, France
| | - D Misdrahi
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, F-33076 Bordeaux, France; CNRS UMR 5287-INCIA, France
| | - R Rey
- Fondation FondaMental, Créteil, France; Université Claude Bernard Lyon 1, Centre Hospitalier Le Vinatier, Pole Est BP 300 39 - 95 bd Pinel, 69678 Bron Cedex, France
| | - C Lancon
- Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), Pôle Universitaire de Psychiatrie, Marseille, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France; Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - P Roux
- Fondation FondaMental, Créteil, France; Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - P Vidailhet
- Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - H Yazbek
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm, 1061, Montpellier, France
| | - F Schürhoff
- Fondation FondaMental, Créteil, France; INSERM U955, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France; Translational Psychiatry Team, Créteil, France
| | - E Bulzacka
- Fondation FondaMental, Créteil, France; INSERM U955, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France; Translational Psychiatry Team, Créteil, France
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Barrett M, Keating A, Lynch D, Scanlon G, Kigathi M, Corcoran F, Sahm LJ. Clozapine Patients at the Interface between Primary and Secondary Care. PHARMACY 2018; 6:E19. [PMID: 29495370 PMCID: PMC5874558 DOI: 10.3390/pharmacy6010019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 02/22/2018] [Accepted: 02/23/2018] [Indexed: 12/17/2022] Open
Abstract
Patients receiving clozapine must undergo routine blood monitoring to screen for neutropenia, and to monitor for potential agranulocytosis. In Cork University Hospital, Cork, Ireland, clozapine is dispensed in the hospital pharmacy and the pharmacists are not aware of co-prescribed medicines, potentially impacting upon patient safety. The aim of this study was to examine the continuity of care of patients prescribed clozapine. A retrospective audit was conducted on patients attending the clozapine clinic at Cork University Hospital and assessed patients' (i) independent living, (ii) co-prescribed medicines and (iii) knowledge of their community pharmacists regarding co-prescribed clozapine. A list of prescribed medicines for each patient was obtained, and potential drug-drug interactions between these medicines and clozapine were examined using Lexicomp® and Stockley's Interaction checker. Secondary outcomes included patients' physical health characteristics, and a review of co-morbidities. Data were collected between the 29 May 2017 and 20 June 2017. Local ethics committee approval was granted. Patients were eligible for inclusion if they were receiving clozapine treatment as part of a registered programme, were aged 18 years or more, and had the capacity to provide written informed consent. Microsoft Excel was used for data analysis. Of 112 patients, (33% female; mean age (SD) 43.9 (11.3) years; 87.5% living independently/in the family home) 86.6% patients reported that they were taking other prescribed medicines from community pharmacies. The mean (SD) number of co-prescribed medicines in addition to clozapine was 4.8 (4) per patient. Two thirds of community pharmacists were unaware of co-prescribed clozapine. Interactions with clozapine were present in all but 3 patients on co-prescribed medicines (n = 97). Lexicomp® reported 2.9 drug-drug interactions/patient and Stockley's Interaction Checker reported 2.5 drug-drug interactions/patient. Secondary outcomes for patients included BMI, total cholesterol, and HbA1c levels, which were elevated in 75%, 54% and 17% respectively. Patients prescribed clozapine did not receive a seamless service, between primary and secondary care settings. Community pharmacists were not informed of clozapine, prescribed for their patients, in two thirds of cases. Patients in this study were exposed to clozapine-related drug-drug interactions and hence potential adverse effects. This study supports reports in the literature of substandard management of the physical health of this patient group. This study shows that there is an opportunity for pharmacists to develop active roles in the management of all clozapine-related effects, in addition to their traditional obligatory role in haematological monitoring. This study supports the need for a clinical pharmacist to review inpatients commencing on clozapine, monitor for drug-drug interactions and provide counselling.
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Affiliation(s)
- Marita Barrett
- Pharmacy Department, Cork University Hospital, Cork T12 DC4A, Ireland.
| | - Anna Keating
- Pharmacy Department, Cork University Hospital, Cork T12 DC4A, Ireland.
| | - Deirdre Lynch
- Pharmacy Department, Cork University Hospital, Cork T12 DC4A, Ireland.
| | - Geraldine Scanlon
- Adult Mental Health Unit, Cork University Hospital, Cork T12 DC4A, Ireland.
| | - Mary Kigathi
- Adult Mental Health Unit, Cork University Hospital, Cork T12 DC4A, Ireland.
| | - Fidelma Corcoran
- Adult Mental Health Unit, Cork University Hospital, Cork T12 DC4A, Ireland.
| | - Laura J Sahm
- School of Pharmacy, University College Cork, Cork T12 YN60, Ireland.
- Pharmacy Department, Mercy University Hospital, Cork T12 WE28, Ireland.
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Šagud M, Vuksan-Ćusa B, Jakšić N, Mihaljević-Peleš A, Živković M, Vlatković S, Prgić T, Marčinko D, Wang W. Nicotine dependence in Croatian male inpatients with schizophrenia. BMC Psychiatry 2018; 18:18. [PMID: 29357830 PMCID: PMC5778660 DOI: 10.1186/s12888-018-1606-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 01/11/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Patients with schizophrenia have the highest known rates of cigarette smoking, but less is known about their smoking behavior and the differences across geographical regions, including Croatia. The aim of this study was to compare patterns of nicotine dependence between patients with schizophrenia and healthy individuals, and to determine the relationship between clinical presentation and the severity of smoking. METHODS This cross-sectional study included 182 recently hospitalized male inpatients and 280 healthy males, who were daily smokers. All participants have fulfilled the Fagerstrom Test for Nicotine Dependence (FTND). Patients were also evaluated by the Positive and Negative Syndrome Scale (PANSS). RESULTS Patients had higher FTND total score (p = 0.010), smoked their first cigarette earlier in the morning (p = 0.000), consumed higher number of cigarettes (p = 0.000), while healthy subjects had more difficulties to refrain from smoking in places where it is forbidden (p = 0.000) and smoked more even when they were sick (p = 0.000). While severe dependence was more prevalent in the patient group, light dependence was more frequent in control subjects (p = 0.04). Smoking behavior was not associated with either PANSS total score or any of its subscales and items. CONCLUSIONS Smokers with schizophrenia differ from healthy smokers in both smoking behavior and level of dependence. Longitudinal studies are needed to shed more light on the complex relationship between smoking and psychopathology in schizophrenia.
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Affiliation(s)
- Marina Šagud
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Psychiatry, University Hospital Center Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia
| | - Bjanka Vuksan-Ćusa
- Department of Psychiatry, University Hospital Center Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia
- School of Medicine, University of Osijek, Osijek, Croatia
- School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Nenad Jakšić
- Department of Psychiatry, University Hospital Center Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia
| | - Alma Mihaljević-Peleš
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Psychiatry, University Hospital Center Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia
| | | | | | - Tea Prgić
- Department of Psychiatry, General Hospital Vinkovci, Vinkovci, Croatia
| | - Darko Marčinko
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Psychiatry, University Hospital Center Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry, Zhejiang University College of Medicine, Hangzhou, China
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Elkholy H, Nagy N, Taha GRA, Elhabiby M, Yosef M, Azzam L. Stop Turning a Blind Eye: Tobacco Smoking Among Egyptian Patients With Schizophrenia. Front Psychiatry 2018; 9:703. [PMID: 30687137 PMCID: PMC6338023 DOI: 10.3389/fpsyt.2018.00703] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 12/03/2018] [Indexed: 11/17/2022] Open
Abstract
Background: Patients with schizophrenia have considerably higher rates of mortality than general population. Multiple factors may play a role in this. Despite being a major preventable cause of death, smoking is usually overlooked when dealing with patients with schizophrenia. Understanding the pattern of smoking, its severity, and the reasons to quit might be helpful in managing patients with schizophrenia and decreasing the mortality gap. Subjects and Methods: The study included smokers divided into two groups; the first included 346 patients with schizophrenia while the second group had 150 smokers with no mental illness. Both groups were assessed and compared regarding sociodemographic variables, pattern of smoking, severity of nicotine dependence, and motivation to quit smoking. Results: Earlier age of starting to smoke, higher number of cigarettes per day, and lower dependency scores were noted in patients with Schizophrenia. Positive correlation was found between positive symptoms and severity of dependence. Specific positive symptoms were correlated to number of cigarettes per day and time before first cigarette. Patients with Schizophrenia showed a significant difference in intrinsic reasons to quit (health concerns and self-control), which were also positively correlated to their positive symptoms score. Linear regression analysis for predictors of FTND score revealed that only age, sex, and schizophrenia were significant predictors of FTND score. Conclusion: Patients with schizophrenia smoke at earlier ages and smoke more cigarettes per day, yet, have less severe dependence than non-schizophrenic counterparts. Positive symptoms play a role in their smoking pattern and severity. Health concerns and self-control are their main motives to quit smoking.
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Affiliation(s)
- Hussien Elkholy
- Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nahla Nagy
- Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ghada R A Taha
- Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud Elhabiby
- Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mostafa Yosef
- Community Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Lobna Azzam
- Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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