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Reasons for the increased prevalence of cigarette smoking in
schizophrenia are unclear. Studies assessing clinical symptoms have
sampled heterogeneous populations, with discrepant findings.
To examine the relationship between clinical features, social adjustment
and nicotine dependence in a geographically defined population of people
Cross-sectional clinical study of 131 people with schizophrenia in
Smokers were younger, mostly males and three times more likely to be
unemployed. Those with severe nicotine dependence had greater scores on
the positive subscale of the Positive and Negative Syndrome Scale
(PANSS), and were prescribed higher doses of antipsychotic. Those with
mild–moderate dependence had greater scores on the PANSS negative
subscale. Greater symptom severity was associated with poorer social
adjustment. Psychopathology and social adjustment were similar in
quitters and never-smokers.
Our findings indicate an association between nicotine dependence,
clinical symptoms and social adjustment in schizophrenia. Although causal
links cannot be inferred, identifying the relationship between nicotine
dependence and psychopathology may have some value in the management of
smoking in schizophrenia. Further longitudinal studies are required to
explore this relationship.
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