Question:
You Don't Have To Be Nuts To Smoke?
Answer:
There is an increased frequency of smoking among patients with schizophrenia.
However, it is unknown whether the smoking behavior of the patients is similar
in all schizophrenia subtypes, as well as which is the relationship between
smoking initiation and disease onset. Four hundred six patients with DSM-IV
schizophrenia were interviewed to determine the smoking status in relationship
to gender and schizophrenic subtype, and to other factors that could affect or
be affected by smoking. The frequency of smoking among patients (58%) was
significantly greater than in subjects from the general population (42%) (P
=.000005). Male patients smoked significantly more frequently (70%) than the
corresponding control subjects (50%) (P =.000006), whereas the difference
failed to reach significance between female patients (41%) and control subjects
(32%). Among male patients, the number of smokers was significantly greater
than in the controls in the paranoid (77%), undifferentiated (72%), and
residual (78%) subtypes, whereas there was no significant difference in the
disorganized (44%) and catatonic (22%) subtypes. The findings show that the
frequency of smoking in schizophrenia patients increases with increasing
positive symptoms and decreases with increasing negative symptoms. Male and
female smoking patients consumed approximately 10 cigarettes per day more than
the corresponding control subjects (P <.000001). In 86% of the patients,
smoking initiation occurred before the disease onset. Among patients who
smoked, smoking initiation and disease onset occurred at age 18.7 +/- 4.4 and
24.1 +/- 6.1 years, respectively (P <.000001). It appears that smoking in
schizophrenia is influenced by gender and subtype. However, the nature of this
association remains uncertain because in the vast majority of the patients
smoking initiation occurs earlier than the disease onset.
As many as 60% of patients with symptoms
that they attribute to environmental pollutants are in fact suffering from
psychological problems, according to a recently released German study.
Lead researcher Dr. Hermann Ebel, director of the Hospital for Psychiatry and
Psychotherapy/Psychosomatic Medicine in Ludwigsburg, notes that cases of
illnesses attributed to pollution in air, water or food are rising. Symptoms
linked to such causes often include headaches, sleeplessness, breathing
difficulties, inability to concentrate and skin problems.
Ebel and a team of environmental scientists, dermatologists, allergists and
psychiatrists evaluated 50 patients who reported symptoms they attributed to
environmental causes, such as pollution.
In many cases, patients were found to have a fixation on environmental dangers
and spent a large amount of time reading news stories or watching TV programs on
the subject, the group told a meeting of the German Society of Psychiatry,
Psychotherapy and Mental Health (DGPPN).
Ebel told Reuters Health that 60% of study participants who displayed symptoms
of such "environmental" illnesses were instead suffering from mental problems.
"This is really not a surprise," he said. "Other studies, in Sweden, the US and
UK, have reached the same conclusion."
Professor Max Schmauss, president of the DGPPN, noted in a statement that such
"environmental" health problems "occur almost exclusively in western industrial
nations. In poorer countries they do not play a role, although the environmental
pollution often represents a still larger problem here. That points on the fact
that this phenomenon is bound by certain cultural and social prerequisites."
Nevertheless, he added, such patients genuinely suffer from their complaints and
are often disabled by their ailments.
Ebel said that determining the psychosomatic nature of symptoms can help
physicians prescribe effective treatments, such as relaxation training and
social skills training.
For patients with depression or phobias, Ebel said, medicines such as
antidepressants or antipsychotics were successful in treating their symptoms.
The German physician conceded that of those 60% whose illnesses appear to be
psychological, a small fraction might be suffering from a disease that cannot be
detected by medical tools now available.
"It is possible that in 10 to 15 years, some illnesses we now think are
psychosomatic (will be found to be) from organic causes," he added. It's nice to know that if we go nuts at least we can still smoke.
Surprising to me that antis haven't gotten smoking banned in the
mental hospitals though.
