Reducing smoking reduces suicidality among individuals with psychosis: Complementary outcomes from a Healthy Lifestyles intervention study

PSYCHIATRY RESEARCH

卷:243

Article

Sankaranarayanan, Anoop^1,2,13  Clark, Vanessa²  Baker, Amanda²  Palazzi, Kerrin³  Lewin, Terry J.^1,2,4  Richmond, Robyn⁵  Kay-Lambkin, Frances J.⁶  Filia, Sacha^7,8  Castle, David^9,10,11  Williams, Jill M.¹² 

[1] Hunter New England Mental Hlth Serv, Callaghan, NSW, Australia

[2] Univ Newcastle, Sch Med & Publ Hlth, Callaghan, NSW, Australia

[3] HMRI, Publ Hlth Program, Newcastle, NSW, Australia

[4] Univ Newcastle, Ctr Translat Neurosci & Mental Hlth, Callaghan, NSW 2308, Australia

[5] Univ New South Wales, Sch Publ Hlth & Community Med, Sydney, NSW, Australia

[6] Univ New South Wales, Natl Drug & Alcohol Res Ctr, NHMRC Ctr Res Excellence Mental Hlth & Substance, Sydney, NSW 2052, Australia

[7] Monash Univ, Cent Clin Sch, Monash Alfred Psychiat Res Ctr, Clayton, Vic 3800, Australia

[8] Alfred Hosp, 55 Commercial Rd, Melbourne, Vic, Australia

[9] St Vincents Hosp, POB 2900, Fitzroy, Vic, Australia

[10] Univ Melbourne, Melbourne, Vic, Australia

[11] Australian Catholic Univ, Fac Hlth Sci, 1100 Nudgee Rd, Banyo, Qld, Australia

[12] Rutgers Robert Wood Johnson Med Sch, Div Addict Psychiat, New Brunswick, NJ USA

[13] Ctr Community Hlth, 65 Brunswick St, Fredericton, NB E3B 1G5, Canada

关键词: Suicide;    Suicidality;    Suicide risk;    Smoking;    Schizophrenia;    Psychosis;   

DOI  :  10.1016/j.psychres.2016.07.006

来源: Elsevier

【 摘 要 】

This study sought to explore the impact of smoking reduction on suicidality (suicide ideation and behaviour) among people with a psychotic disorder (n=235) who participated in a randomized trial of a healthy lifestyle intervention trial. Suicidality, measured by item -4 of the Brief Psychiatric Rating Scale (BPRS) was the main variable of interest. Measures were collected by research assistants blind to treatment allocation at baseline, at 15 weeks (mid-intervention) and 12 months after baseline. Mediation analysis, adjusted for confounders, was used to determine the relationship between smoking reduction and suicidality and to explore whether this was mediated through depression. At 12 months, smoking reduction was found to be significantly associated with suicidality change; an association was also seen between smoking reduction and depression and depression and suicidality. After adjusting for depression, the association between smoking reduction and suicidality was attenuated but remained statistically significant; the proportion of the total effect that was mediated through depression was 30%. There was no significant association between suicidality and treatment group (vs. controls) over time. Our study suggests that smoking interventions may have benefits over and above those for improved physical health, by reducing suicidal ideation in people with psychosis. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

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