Predictors of Early Abstinence in Smokers With Schizophrenia
Predictors of Early Abstinence in Smokers With Schizophrenia
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DOI：
10.4088/jcp.v69n1109
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发表时间：
2008-11-01
影响因子：
5.3
通讯作者：
Evins, A. Eden
中科院分区：
文献类型：
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作者：
Culhane, Melissa A.;Schoenfeld, David A.;Evins, A. Eden
背景：精神分裂症患者的戒烟率较低，与吸烟相关的发病率和死亡率负担很高。识别与禁欲相关的因素，可以让临床医生优化治疗前戒烟attempt.Method：要确定成功戒烟的精神分裂症患者的DSM-IV诊断的相关因素，我们分析了基线数据，从114个稳定的门诊吸烟者与精神分裂症谁参加了我的2戒烟试验。关注的结果是在12周尼古丁依赖治疗干预结束时持续戒断4周。与禁欲相关的基线因素采用单变量方法确定，并输入手动、前向选择多变量回归模型，以确定禁欲的独立预测因素。结果：14/114例（12%）受试者在第12周时经生化检查证实已连续戒断4周。我们在多变量模型中纳入了10个与禁欲单变量相关的非相关变量，控制了药物治疗、年龄和性别。开始吸烟时的年龄和注意力的基线变异性（通过连续操作测试-AX（CPT-AX）命中反应时间标准误测量）与戒烟独立相关。开始吸烟时年龄每增加一年，戒烟的OR为1.36（95% CI = 1.01至1.83），p = 0.048。CPT-AX反应时变异性每减少1毫秒，戒烟成功的OR值为1.55（95%CI = 1.07~2.24），p = 0.021。结论：晚开始吸烟与注意力损害增加和基线注意力损害相关，戒烟成功率降低。进一步的研究，以进一步了解精神分裂症中注意力障碍和吸烟之间的关系，可能会导致改善这一群体的尼古丁依赖治疗。
Background: In patients with schizophrenia, the smoking cessation rate is low and the burden of smoking-related morbidity and mortality is high. Identification of factors associated with abstinence may allow clinicians to optimize treatment prior to a smoking cessation attempt.Method: To identify factors associated with successful smoking cessation in patients with a DSM-IV diagnosis of schizophrenia, we analyzed baseline data from 114 stable outpatient smokers with schizophrenia who participated in I of 2 smoking cessation trials. The outcome of interest was 4 weeks' continuous abstinence at the end of a 12-week nicotine dependence treatment intervention. Baseline factors associated with abstinence were identified with univariate methods and entered into a manual, forward-selection multivariable regression model to identify independent predictors of abstinence. The study was conducted from March 1999 to February 2004.Results: Fourteen of 114 participants (12%) had biochemically verified 4 weeks' continuous abstinence at week 12. We included 10 non-correlated variables with a univariate association with abstinence in a multivariable model, controlling for pharmacotherapy, age, and gender. Age at initiation of smoking and baseline variability in attentiveness, as measured by Continuous Performance Test-AX (CPT-AX) hit reaction time standard error, were independently associated with abstinence. For every year increase in age at initiation of smoking, the OR for abstinence was 1.36 (95% CI = 1.01 to 1.83), p = .048. For every millisecond decrease in the variability of the reaction time of CPT-AX the OR for achieving abstinence was 1.55 (95% CI = 1.07 to 2.24), p = .021.Conclusion: Later initiation of smoking was associated with increased and baseline attentional impairment with reduced odds of abstinence. Additional research to further our understanding of the relationship between attentional impairment and cigarette smoking in schizophrenia may lead to improved nicotine dependence treatments for this group.