The Evaluation of The Nicotine Dependence in Psychiatric Disorders

Abstract

Objective: A relationship has been suggested between recurrent major depression and high nicotine dependence. A similar relevance may establish a reference for further investigations evaluating the role of nicotine dependence on various psychiatric disorders. For this purpose, we assessed the frequency of smoking and nicotine dependence, according to psychiatric diagnosis in psychiatric outpatients.

Methods:  A total of 1036 psychiatric patients were included in this descriptive study. The participants were evaluated according to DSM IV (Diagnostic and Statistical Manual of Mental Disorders, 4th. Edition) for psychiatric disorders and Fagerström Test for Nicotine Dependence (FTND) that was applied to define smoking habits.

Results: The overall smoking rate was 40.2% (n=1036), while the smoking rate of females and males was 32.6% (n=229) and 56.0% (n=187) (p<0.001) respectively. The mean age of onset of smoking, and the mean FTND score were significantly higher in men than women [The mean age of onset of smoking was 19.6 ± 6.5 years in women, and 16.8 ± 6.0 years in men (p<0.001). The mean FTND score in women and men was 3.9 ± 2.7 and 5.1 ± 2.6 (p<0.001)]. The age of onset of smoking, the number of smoking cessation trials, FTND scores, and the smoking cessation request of patients with psychotic disorders were significantly lower than patients with affective disorders and anxiety disorders (respectively p=0.008, p=0.047, p<0.001, p=0.015).

Conclusion: The lower ratio of high nicotine dependence in psychotic disorder in comparison to affective and anxiety disorders may give insight to the role of nicotine in the pathogenesis of the psychiatric diseases.

Keywords

• smoking,psychiatric patients,nicotine dependence,outpatients

Psikiyatrik Hastalıklarda Nikotin Bağımlılığının Değerlendirilmesi

Abstract

Amaç: Yüksek nikotin bağımlılığıyla tekrarlayan major depresyon arasında ilişki olduğu bildirilmiştir. Benzer bir ilişkinin diğer psikiyatrik hastalıklarda saptanmasında nikotin bağımlılık düzeylerinin araştırılması ileriki çalışmalara yön verecektir. Bu amaçla ayaktan psikiyatrik hastalarda, psikiyatrik tanılara göre sigara içme sıklığını ve nikotin bağımlılık düzeyini diğer ilişkili faktörler ekseninde inceledik.

Gereç Ve Yöntem: Bu tanımlayıcı çalışmaya toplam 1036 ayaktan psikiyatri hastası dâhil edildi. Hastaların psikiyatrik tanıları DSM-IV’e göre ve nikotin bağımlılıkları Fagerström Nikotin Bağımlılık Testi (FNBT) ile ele alındı.

Bulgular: Genel sigara içme oranı %40,2 (n = 416); kadınların sigara içme oranı %32,6 (n = 229) ve erkeklerin %56,0 (n = 187) idi (p<0,001). Erkek hastaların sigaraya başlama yaşı ve FNBT puanları kadınlardan istatistiksel olarak daha yüksekti (p<0,001). Psikotik bozukluğu olan hastalarda sigara başlama yaşı, sigarayı bırakma deneme sayısı, FNBT skoru ve sigarayı bırakma isteği, duygudurum bozukluğu ve anksiyete bozukluğu olan hastalardan istatistiksel olarak daha düşüktü (sırasıyla p=0,008, p=0,047, p<0,001, p=0,015).

Sonuç: Psikotik bozuklukta, duygudurum ve anksiyete bozukluğuna göre yüksek nikotin bağımlılığı oranı daha düşüktür.

Keywords

• tütün kullanımı,psikiyatri hastaları,nikotin bağımlılığı,ayaktan hastalar

References

1. 1. Kreinin A, Novitski D, Rabinowitz D, et al. Association between tobacco smoking and bipolar affective disorder: clinical, epidemiological, cross-sectional, retrospective study in outpatients. Compr Psychiatry 2012;53(3):269-74.
2. 2. Tanriover O, Karamustafalioglu N, Tezvaran Z, et al. Frequency of cigarette smoking among psychiatric inpatients evaluated by the Fagerström Test for Nicotine Dependence. Asian Pac J Cancer Prev 2013;14(1):579-82.
3. 3. Hughes JR, Hatsukami DK, Mitchell JE, et al. Prevalence of smoking among psychiatric out-patients. Am J Psychiatry 1986;143:993-7.
4. 4. Lasser K, Boyd JW, Woolhandler S, et al. Smoking and mental illness: a population-based prevalence study. JAMA 2000;284:2606-10.
5. 5. Hennekens CH, Hennekens AR, Hollar D, et al. Schizophrenia and increased risks of cardiovascular disease. Am. Heart J 2005;150:1115–21.
6. 6. Colton CW, Manderscheid RW. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Prev Chronic Dis 2006;3:1-14.
7. 7. Aubin HJ, Rollema H, Svensson TH, et al. Smoking, quitting, and psychiatric disease: a review. Neurosci Biobehav Rev 2012;36(1):271-84.
8. 8. Itkin O, Nemets B, Einat H. Smoking habits in bipolar and schizophrenic outpatients in southern Israel. J Clin Psychiatry 2001;62(4):269–72.

9. 9. De Leon J, Diaz FJ. A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors. Schizophr Res 2005;1576(2–3):135–57.
10. 10. Zhang XY, Chen da C, Tan YL, et al. Socio-demographic and clinical characteristics of heavy and non-heavy smokers among schizophrenia inpatients in a Chinese Han population. Psychopharmacology (Berl) 2014;231(1):305-14.
11. 11. Wehring HJ, Liu F, McMahon RP, et al. Clinical characteristics of heavy and non-heavy smokers with schizophrenia. Schizophr Res 2012;138(2–3):285–9.
12. 12. Kelly DL, Raley HG, Lo S, et al. Perception of smoking risks and motivation to quit among nontreatment-seeking smokers with and without schizophrenia. Schizophr Bull 2012; 38(3):543–51.
13. 13. Waxmonsky JA, Thomas MR, Miklowitz DJ, et al. Prevalence and correlates of tobacco use in bipolar disorder: data from the first 2000 participants in the Systematic Treatment Enhancement Program. Gen Hosp Psychiatry 2005;27:319-20.
14. 14. Ostacher MJ, Nierenberg AA, Perlis RH, et al. The relationship between smoking and suicidal behavior, comorbidity, and course of illness in bipolar disorder. J Clin Psychiatry 2006;67:1907-11.
15. 15. Oquendo MA, Galfalvy H, Russo S, et al. Prospective study of clinical predictors of suicidal acts after a major depressive episode in patients with major depressive disorder or bipolar disorder. Am J Psychiatry 2004;161:1433-41.
16. 16. Baker-Morissette SL, Gulliver SB, Wiegel M, et al. Prevalence of smoking in anxiety disorders uncomplicated by comorbid alcohol or substance abuse. J Psychopathol Behav Assess 2004;26(2):107-12.
17. 17. Strong DR, Cameron A, Feuer S, et al. Single versus recurrent depression history: differentiating risk factors among current US smokers. Drug Alcohol Depend 2010;109:90–5.
18. 18. Pedersen W, Von Soest T. Smoking, nicotine dependence and mental health among young adults: a 13-year population-based longitudinal study. Addiction 2009;104:129–37.
19. 19. Yargıç İ, Baykan H. Severe mental disorders, depression and smoking cessation. Anadolu Psikiyatri Derg. 2013;14(1):77-83.
20. 20. Uysal MA, Kadakal F, Karşidag C, et al. Fagerström test for nicotine dependence: reliability in a Turkish sample and factor analysis. Tuberk Toraks 2004;52:115-21.
21. 21. Ertekin H, Aydın M, Aslan M, et al. Are psychiatric outpatients assessed for smoking? Konuralp Tıp Dergisi 2017;9(2):78-82.
22. 22. Kuloğlu M, Atmaca M. Nicotine dependence in patients who applied to a psychiatry clinic. Kriz Dergisi 2001;9(1):33-8.
23. 23. ChoiS, Rankin S, Stewart A, Oka R. Effects of acculturation on smoking behavior in Asian Americans: a meta-analysis. J Cardiovasc Nurs 2008;23(1):67-73.
24. 24. Myung SK, Ju W, Jung HS, et al. Efficacy and safety of pharmacotherapy for smoking cessation among pregnant smokers: a meta-analysis. BJOG 2012;119(9):1029-39.
25. 25. Kim SS, Chung S, Park JI, et al. Smoking among individuals with schizophrenia in Korea: gender differences. Arch Psychiatr Nurs 2013;27(5):241-5.
26. 26. Kelly C, McCreadie RG. Smoking habits, current symptoms, and premorbid characteristics of schizophrenic patients in Nithsdale, Scotland. Am J Psychiatry 1999;156:1751–7.
27. 27. Ziedonis DM, George TP Schizophrenia and nicotine use: report of a pilot smoking cessation program and review of neurobiological and clinical issues. Schizophr Bull 1997;23(2):247-54.
28. 28. Itkin, Lasser K, Boyd JW, Woolhandler S, et al. Smoking and mental illness: a population-based prevalence study. JAMA 2000;284(20):2606 – 10.
29. 29. Gonzalez-Pinto A, Gutierrez M, Ezcurra J et al. Tobacco smoking and bipolar disorder. J Clin Psychiatry 1998;59:225-8.