Minimal effects of prolonged smoking abstinence or resumption on cognitive performance challenge the self-medication hypothesis in schizophrenia

SCHIZOPHRENIA RESEARCH

卷:194

Article

Boggs, Douglas L.^1,2  Surti, Toral S.^1,2  Esterlis, Irina^1,2,3  Pittman, Brian^2,3  Cosgrove, Kelly^1,2,3  Sewell, R. Andrew^1,2,3  Ranganathan, Mohini^1,2,3  D'Souza, Deepak Cyril^1,2,3 

[1] VA Connecticut Healthcare Syst, Psychiat Serv, 950 Campbell Ave, West Haven, CT 06516 USA

[2] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA

[3] Connecticut Mental Hlth Ctr, Abraham Ribicoff Res Facil, 34 Pk St, New Haven, CT 06519 USA

关键词: Schizophrenia;    Cognition;    Smoking;    Nicotine;    Tobacco;    Withdrawal;    Abstinence;   

DOI  :  10.1016/j.schres.2017.03.047

来源: Elsevier

【 摘 要 】

One prominent, long-standing view is that individuals with schizophrenia smoke cigarettes more than the general population to self-medicate cognitive deficits and other symptoms. This study tested the self-medication hypothesis by examining the effects of smoking abstinence and resumption on cognition in patients with schizophrenia. Nicotine-dependent smokers with schizophrenia (n=26) were trained on a cognitive battery and then hospitalized to achieve and maintain confirmed abstinence from smoking for similar to 1 week. Cognition was tested while smoking as usual (baseline), one day after smoking cessation (early abstinence), similar to 1 week later (extended abstinence), and within similar to 3weeks of resuming smoking (resumption). The test battery included measures of processing speed, attention, conflict resolution, verbal memory, working memory, verbal fluency, and executive function to evaluate multiple cognitive domains affected by schizophrenia. Positive and negative symptoms of schizophrenia, depressive symptoms, and dyskinesia were also measured at baseline and after prolonged abstinence. There were no significant changes in global cognitive test performance with smoking cessation, abstinence, or resumption. There were small decreases in a measure of processing speed and delayed verbal recall with abstinence, but these findings failed to survive adjustments for multiple comparisons. Surprisingly, in this within subject On-Off-Off-On design, there were no significant effects of early or prolonged abstinence from smoking on cognitive and behavioral measures in smokers with schizophrenia. The results of this study challenge the widely held self-medication hypothesis of smoking and schizophrenia, question the extent of pro-cognitive effects of smoking and nicotine in schizophrenia, and support encouraging smoking cessation in schizophrenia. Published by Elsevier B.V.

【 授权许可】

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