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S154. TOBACCO SMOKING AND CLINICAL HIGH RISK: A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EVIDENCE

BACKGROUND: There is converging evidence that youths at clinical high risk (CHR) are not only likely to develop the first episode of psychosis but also to develop poor physical outcomes. Some physical health risk factors - such as smoking - have been shown to increase the probability of a frank onse...

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Autores principales: De Micheli, Andrea, van Lawick van Pabst, Albertine, Yossef, Enass, McGuire, Philip, Fusar-Poli, Paolo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234667/
http://dx.doi.org/10.1093/schbul/sbaa031.220
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author De Micheli, Andrea
van Lawick van Pabst, Albertine
Yossef, Enass
McGuire, Philip
Fusar-Poli, Paolo
author_facet De Micheli, Andrea
van Lawick van Pabst, Albertine
Yossef, Enass
McGuire, Philip
Fusar-Poli, Paolo
author_sort De Micheli, Andrea
collection PubMed
description BACKGROUND: There is converging evidence that youths at clinical high risk (CHR) are not only likely to develop the first episode of psychosis but also to develop poor physical outcomes. Some physical health risk factors - such as smoking - have been shown to increase the probability of a frank onset of psychosis in those at risk. A meta-analysis conducted in psychotic patients confirmed that daily tobacco use is associated with an increased risk of psychosis. A significant association between any attenuated psychotic symptoms (that characterize CHR state) and cigarette smoking has been recently shown in a study conducted in South London. Nowadays, it is not completely clear how these findings would translate to the CHR population but a better understanding of how physical health parameters could affect psychopathological outcomes could be beneficial for these vulnerable clinical populations. To shed light on the percentage of smokers in CHR populations, an updated systematic review and meta-analysis of the literature has been carried out. Our main aim was to test whether the probability of being a smoker was higher in the CHR subjects or in the control group. METHODS: The literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We systematically scrutinized from literature inception to 2019 the following on-line databases: Web of Science Core Collection, BIOSIS Citation Index, KCL-Korean Journal Database, MEDLINE, Russian Science Citation Index, SCiELO Citation Index. We have considered all the relevant studies reporting the smoking status in CHR subjects and in control groups. We used the odds ratio (OR) as effect size measure and data were pooled using a random effect approach. RESULTS: Preliminary data show that CHR individuals were more likely to use tobacco that matched healthy controls. Specifically, the overall OR of 2.016 (p<.001 95%CI=1.476–2.749) indicated a higher likelihood that CHR individuals would use tobacco compared to controls. Heterogeneity was not significant (I²=30.193 p=0.11). The visual inspection of funnel plots did not reveal a clear suggestion for publication bias and the Egger’s test was non-significant (p=0.10). DISCUSSION: Our systematic review and meta-analysis suggest that is crucial to investigate physical health outcomes such as tobacco use as part of clinical practice in CHR services. Unfortunately, current CHR assessment tools are entirely based on the measurement of psychopathological features and do not include an assessment of these parameters on a regular basis.
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spelling pubmed-72346672020-05-23 S154. TOBACCO SMOKING AND CLINICAL HIGH RISK: A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EVIDENCE De Micheli, Andrea van Lawick van Pabst, Albertine Yossef, Enass McGuire, Philip Fusar-Poli, Paolo Schizophr Bull Poster Session I BACKGROUND: There is converging evidence that youths at clinical high risk (CHR) are not only likely to develop the first episode of psychosis but also to develop poor physical outcomes. Some physical health risk factors - such as smoking - have been shown to increase the probability of a frank onset of psychosis in those at risk. A meta-analysis conducted in psychotic patients confirmed that daily tobacco use is associated with an increased risk of psychosis. A significant association between any attenuated psychotic symptoms (that characterize CHR state) and cigarette smoking has been recently shown in a study conducted in South London. Nowadays, it is not completely clear how these findings would translate to the CHR population but a better understanding of how physical health parameters could affect psychopathological outcomes could be beneficial for these vulnerable clinical populations. To shed light on the percentage of smokers in CHR populations, an updated systematic review and meta-analysis of the literature has been carried out. Our main aim was to test whether the probability of being a smoker was higher in the CHR subjects or in the control group. METHODS: The literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We systematically scrutinized from literature inception to 2019 the following on-line databases: Web of Science Core Collection, BIOSIS Citation Index, KCL-Korean Journal Database, MEDLINE, Russian Science Citation Index, SCiELO Citation Index. We have considered all the relevant studies reporting the smoking status in CHR subjects and in control groups. We used the odds ratio (OR) as effect size measure and data were pooled using a random effect approach. RESULTS: Preliminary data show that CHR individuals were more likely to use tobacco that matched healthy controls. Specifically, the overall OR of 2.016 (p<.001 95%CI=1.476–2.749) indicated a higher likelihood that CHR individuals would use tobacco compared to controls. Heterogeneity was not significant (I²=30.193 p=0.11). The visual inspection of funnel plots did not reveal a clear suggestion for publication bias and the Egger’s test was non-significant (p=0.10). DISCUSSION: Our systematic review and meta-analysis suggest that is crucial to investigate physical health outcomes such as tobacco use as part of clinical practice in CHR services. Unfortunately, current CHR assessment tools are entirely based on the measurement of psychopathological features and do not include an assessment of these parameters on a regular basis. Oxford University Press 2020-05 2020-05-18 /pmc/articles/PMC7234667/ http://dx.doi.org/10.1093/schbul/sbaa031.220 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Session I
De Micheli, Andrea
van Lawick van Pabst, Albertine
Yossef, Enass
McGuire, Philip
Fusar-Poli, Paolo
S154. TOBACCO SMOKING AND CLINICAL HIGH RISK: A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EVIDENCE
title S154. TOBACCO SMOKING AND CLINICAL HIGH RISK: A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EVIDENCE
title_full S154. TOBACCO SMOKING AND CLINICAL HIGH RISK: A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EVIDENCE
title_fullStr S154. TOBACCO SMOKING AND CLINICAL HIGH RISK: A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EVIDENCE
title_full_unstemmed S154. TOBACCO SMOKING AND CLINICAL HIGH RISK: A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EVIDENCE
title_short S154. TOBACCO SMOKING AND CLINICAL HIGH RISK: A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EVIDENCE
title_sort s154. tobacco smoking and clinical high risk: a systematic review and meta-analysis of the evidence
topic Poster Session I
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234667/
http://dx.doi.org/10.1093/schbul/sbaa031.220
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