In an attempt to understand the reasons behind the high prevalence of tobacco smoking in patients with schizophrenia, the study examined whether specific symptoms of schizophrenia were associated with smoking. Standardized assessments of nicotine dependence (Fagerstrom Test for Nicotine Dependence) and psychopathology (Positive and Negative Syndrome Scale) were performed on 87 inpatients with schizophrenia. Nearly 76% of patients were nicotine dependent. Significant positive correlations were found between Fagerstrom scores and the total negative symptom score and scores on the negative symptom subscales of blunted affect, social withdrawal, difficulty in abstract thinking, and stereotyped thinking. Fagerstrom scores were also significantly associated with impairment in attention, orientation, thinking, and impulse control. Positive symptoms were not significantly associated with smoking. A combination of negative symptoms, duration of illness, and alcohol use optimally predicted smoking in the sample. Neurobiological mechanisms could possibly underlie some of our findings and require further investigation.
1Department of Psychiatry and Human Behavior, Thomas Jefferson University, 833 Chestnut Street East, Suite 210E, Philadelphia, Pennsylvania, 19107. Send reprint requests to Dr. Patkar.
2Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania.
A part of this research was presented at the annual meeting of the American Psychiatric Association, Washington DC, May 1999.