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Nicotine consumption during the prodromal phase of schizophrenia – a review of the literature

Recent research has fueled a debate concerning the role of nicotine in the emergence of schizophrenia. The three main hypotheses are: (a) the self-medication effect, (b) the causal relationship hypothesis, or (c) the shared diathesis hypothesis. To explore this role, the study of nicotine consumptio...

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Autores principales: Gogos, Athanasios, Skokou, Maria, Ferentinou, Eleni, Gourzis, Philippos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801495/
https://www.ncbi.nlm.nih.gov/pubmed/31802874
http://dx.doi.org/10.2147/NDT.S210199
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author Gogos, Athanasios
Skokou, Maria
Ferentinou, Eleni
Gourzis, Philippos
author_facet Gogos, Athanasios
Skokou, Maria
Ferentinou, Eleni
Gourzis, Philippos
author_sort Gogos, Athanasios
collection PubMed
description Recent research has fueled a debate concerning the role of nicotine in the emergence of schizophrenia. The three main hypotheses are: (a) the self-medication effect, (b) the causal relationship hypothesis, or (c) the shared diathesis hypothesis. To explore this role, the study of nicotine consumption during the initial prodromal phase of schizophrenia offers important opportunities. In the present work, 10 relevant studies are reviewed, out of 727 retrieved citations, in order to address questions regarding the prevalence of smoking in the prodromal period, the time of smoking initiation, existing patterns of tobacco use in relation with the escalation of prodromal symptoms into first psychotic episode, and potential differences in symptomatology between smokers and nonsmokers. Even though there was considerable heterogeneity among studies, relevant findings are discussed. Prevalence of nicotine use during the prodromal period was reported to be 16.6–46%. Tobacco use was found to be taken up most often before or during the prodromal period of schizophrenia. Even though a protective role of smoking has been reported by one study, other studies report an increased risk for psychosis, with hazard ratios 2.77 (95% CI: 2.34–3.43) and 2.21 (95% CI: 1.11–4.42) for female and male heavy smokers (11–20 and >20 cigarettes/day), respectively. In a different study, the risk of onset was associated with the progressive use of cannabis and tobacco prior to onset, particularly with rapid escalation to the highest levels of use. Also, nicotine use in ultra high risk (UHR) for developing psychosis subjects is associated with elevated cognitive performance, namely better processing speed, visual learning, and spatial working memory. As a conclusion, it appears that evidence accumulates supporting a possible etiologic role of smoking, in the emergence of schizophrenia along with diverse effects on patients’ symptomatology, already demonstrable at the prodromal phase. Future research employing better-defined criteria should further explore the patterns of use and effects of nicotine during the schizophrenia prodrome.
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spelling pubmed-68014952019-12-04 Nicotine consumption during the prodromal phase of schizophrenia – a review of the literature Gogos, Athanasios Skokou, Maria Ferentinou, Eleni Gourzis, Philippos Neuropsychiatr Dis Treat Review Recent research has fueled a debate concerning the role of nicotine in the emergence of schizophrenia. The three main hypotheses are: (a) the self-medication effect, (b) the causal relationship hypothesis, or (c) the shared diathesis hypothesis. To explore this role, the study of nicotine consumption during the initial prodromal phase of schizophrenia offers important opportunities. In the present work, 10 relevant studies are reviewed, out of 727 retrieved citations, in order to address questions regarding the prevalence of smoking in the prodromal period, the time of smoking initiation, existing patterns of tobacco use in relation with the escalation of prodromal symptoms into first psychotic episode, and potential differences in symptomatology between smokers and nonsmokers. Even though there was considerable heterogeneity among studies, relevant findings are discussed. Prevalence of nicotine use during the prodromal period was reported to be 16.6–46%. Tobacco use was found to be taken up most often before or during the prodromal period of schizophrenia. Even though a protective role of smoking has been reported by one study, other studies report an increased risk for psychosis, with hazard ratios 2.77 (95% CI: 2.34–3.43) and 2.21 (95% CI: 1.11–4.42) for female and male heavy smokers (11–20 and >20 cigarettes/day), respectively. In a different study, the risk of onset was associated with the progressive use of cannabis and tobacco prior to onset, particularly with rapid escalation to the highest levels of use. Also, nicotine use in ultra high risk (UHR) for developing psychosis subjects is associated with elevated cognitive performance, namely better processing speed, visual learning, and spatial working memory. As a conclusion, it appears that evidence accumulates supporting a possible etiologic role of smoking, in the emergence of schizophrenia along with diverse effects on patients’ symptomatology, already demonstrable at the prodromal phase. Future research employing better-defined criteria should further explore the patterns of use and effects of nicotine during the schizophrenia prodrome. Dove 2019-10-16 /pmc/articles/PMC6801495/ /pubmed/31802874 http://dx.doi.org/10.2147/NDT.S210199 Text en © 2019 Gogos et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Gogos, Athanasios
Skokou, Maria
Ferentinou, Eleni
Gourzis, Philippos
Nicotine consumption during the prodromal phase of schizophrenia – a review of the literature
title Nicotine consumption during the prodromal phase of schizophrenia – a review of the literature
title_full Nicotine consumption during the prodromal phase of schizophrenia – a review of the literature
title_fullStr Nicotine consumption during the prodromal phase of schizophrenia – a review of the literature
title_full_unstemmed Nicotine consumption during the prodromal phase of schizophrenia – a review of the literature
title_short Nicotine consumption during the prodromal phase of schizophrenia – a review of the literature
title_sort nicotine consumption during the prodromal phase of schizophrenia – a review of the literature
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801495/
https://www.ncbi.nlm.nih.gov/pubmed/31802874
http://dx.doi.org/10.2147/NDT.S210199
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