Effects of acute smoking abstinence among people with schizophrenia: A systematic review and meta-analysis of laboratory studies

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research Pub Date : 2024-09-30 DOI:10.1016/j.schres.2024.09.025

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引用次数: 0

Abstract

Background

Smoking rates in schizophrenia are exceptionally high; however, cessation rates remain low with limited research on effective interventions. A critical component of intervention development is identifying the effects of abstinence that are most salient and therefore may contribute to lapse and relapse.

Objectives

We conducted a systematic review and meta-analysis of controlled laboratory studies investigating acute smoking abstinence effects among people with schizophrenia and schizoaffective disorder.

Methods

This review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. OVID (MEDLINE, EMBASE, PsycINFO) and PubMed databases were searched from inception until November 2023.

Results

We identified (k = 16) articles meeting inclusion criteria; all assessed smoking abstinence (ranging 2–120 h). Acute abstinence resulted in large increases in reward-oriented craving and moderate increases in relief-oriented craving; these effects were greater in studies with longer abstinence duration (high certainty). We also observed significant increases in negative affect and global withdrawal symptoms, as well as memory disruption (moderate certainty). Qualitative synthesis suggests restlessness, irritability, anxiety, and visuospatial working memory may be additionally impacted. Findings with respect to negative symptoms and movement were mixed.

Conclusions

Reward-oriented craving may constitute a key target of smoking cessation interventions for people with schizophrenia. In addition, identification of pharmacological and psychosocial interventions that address abstinence-induced changes in relief-oriented craving, memory, negative affect, restlessness, irritability, and anxiety may strengthen treatment outcomes.

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精神分裂症患者急性戒烟的效果：实验室研究的系统回顾和荟萃分析

背景精神分裂症患者的吸烟率极高；然而，戒烟率仍然很低，有效干预措施的研究也很有限。我们对精神分裂症和分裂情感障碍患者急性戒烟效果的实验室对照研究进行了系统综述和荟萃分析。检索了OVID（MEDLINE、EMBASE、PsycINFO）和PubMed数据库，检索时间从开始到2023年11月。结果我们发现（k = 16）篇文章符合纳入标准；所有文章都对戒烟（2-120小时不等）进行了评估。急性戒烟导致以回报为导向的渴求大幅增加，以解脱为导向的渴求适度增加；在戒烟持续时间较长的研究中，这些影响更大（高度确定性）。我们还观察到消极情绪和全面戒断症状以及记忆中断的明显增加（中等确定性）。定性综合分析表明，烦躁不安、易怒、焦虑和视觉空间工作记忆可能会受到额外影响。结论以奖赏为导向的渴求可能是精神分裂症患者戒烟干预的关键目标。此外，针对戒烟引起的缓解型渴求、记忆、负性情绪、烦躁不安、易激惹和焦虑的变化，确定药物和心理干预措施可能会加强治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Schizophrenia Research 医学-精神病学

CiteScore

7.50

自引率

8.90%

发文量

429

审稿时长

10.2 weeks

期刊介绍： As official journal of the Schizophrenia International Research Society (SIRS) Schizophrenia Research is THE journal of choice for international researchers and clinicians to share their work with the global schizophrenia research community. More than 6000 institutes have online or print (or both) access to this journal - the largest specialist journal in the field, with the largest readership! Schizophrenia Research''s time to first decision is as fast as 6 weeks and its publishing speed is as fast as 4 weeks until online publication (corrected proof/Article in Press) after acceptance and 14 weeks from acceptance until publication in a printed issue. The journal publishes novel papers that really contribute to understanding the biology and treatment of schizophrenic disorders; Schizophrenia Research brings together biological, clinical and psychological research in order to stimulate the synthesis of findings from all disciplines involved in improving patient outcomes in schizophrenia.