Tobacco use in first-episode psychosis, a multinational EU-GEI study

BACKGROUND

Tobacco is a highly prevalent substance of abuse in patients with psychosis. Previous studies have reported an association between tobacco use and schizophrenia. The aim of this study was to analyze the relationship between tobacco use and first-episode psychosis (FEP), age at onset of psychosis, and specific diagnosis of psychosis.

METHODS

The sample consisted of 1105 FEP patients and 1355 controls from the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study. We assessed substance use with the Tobacco and Alcohol Questionnaire and performed a series of regression analyses using case-control status, age of onset of psychosis, and diagnosis as outcomes and tobacco use and frequency of tobacco use as predictors. Analyses were adjusted for sociodemographic characteristics, alcohol, and cannabis use.

RESULTS

After controlling for cannabis use, FEP patients were 2.6 times more likely to use tobacco [p ⩽ 0.001; adjusted odds ratio (AOR) 2.6; 95% confidence interval (CI) [2.1-3.2]] and 1.7 times more likely to smoke 20 or more cigarettes a day (p = 0.003; AOR 1.7; 95% CI [1.2-2.4]) than controls. Tobacco use was associated with an earlier age at psychosis onset (β = -2.3; p ⩽ 0.001; 95% CI [-3.7 to -0.9]) and was 1.3 times more frequent in FEP patients with a diagnosis of schizophrenia than in other diagnoses of psychosis (AOR 1.3; 95% CI [1.0-1.8]); however, these results were no longer significant after controlling for cannabis use.

CONCLUSIONS

Tobacco and heavy-tobacco use are associated with increased odds of FEP. These findings further support the relevance of tobacco prevention in young populations.

Quality of life measures in schizophrenia

The recognition of the importance of evaluating the quality of life of patients with schizophrenia highlighted the importance ofdeveloping appropriate instruments. In this paper we review the available quality of life instruments focusing on their conceptual framework, structure, administration and psychometric properties. First, we address the generic instruments that have been validated for schizophrenic populations, namely the World Health Organization Quality of Life Assessment (WHOQOL), the Medical Outcome Study (MOS) 36-Item Short-Form Health Survey (SF-36) and the EuroQoL-5 Dimensions (EQ-5D). Then, we focus on instruments that have been specifically developed for patients with schizophrenia and other or severe mentally illness such as the Quality of Life Scale (QLS), the Quality of Life Interview (QoLI), the Lancashire Quality of Life Profile (LQoLP), the Sevilla Quality of Life Questionnaire (SQLQ), the Personal Evaluation of Transitions in Treatment (PETIT), and the Quality of Life Questionnaire in Schizophrenia (S-QoL).

Suicide attempts and suicide ideation in adolescents: SDQ scores in the Spanish sample of “saving and empowering young lives in Europe” (SEYLE) project

Introduction

Behaviour disorders in adolescents are a risk factor associated with suicidal behavior.

Aim

To examine the distribution of the Strengths and Difficulties Questionnaire (SDQ) scores in the Spanish sample of adolescents from the “Saving and Empowering Young Lives in Europe” (SEYLE) project and study the differences according to the gender and the relationship with both suicide attempts (SA) and suicidal ideation (SI).

Method

875 pupils from 12 secondary schools sited in Asturias (Spain) [50.7% males; mean age (SD) =14.5 (0.72)] were assessed through the SDQ and Paykel Suicide Scale (PSS).

Results

No significant differences were found in the SDQ total score by gender, but were found (p< 0.001) in some subscales as emotional symptoms (t=-6.769) (women scoring higher), hyperactivity (t=3.283) and prosocial (t=5.260) (men scoring higher). Regarding PSS, 3.1% tried to take their life during past six months. No significant differences were found in SA by gender but were found (p< 0.050) for the thought that life not worth (t=-3.597), women scoring higher, and about wish to be dead (t=-2.630), men scoring higher. Previous SA were significant related (p< 0.001) with SDQ total score (X2=38,437), emotional symptoms (X2=25,528), hyperactivity (X2=13,572) and behaviour disorders (X2=7,505). SI was significant related (p< 0.001) with SDQ total score (X2=38,437), emotional symptoms (X2=31,077), behaviour disorders (X2=33,011), peer problems (X2=35,161) and prosocial behavior (X2=17,978).

Conclusion

SA and SI were related with difficulties (SDQ criteria), mainly on emotional symptoms and behaviour disorders. Prevention strategies in high risk groups are likely to become increasingly important.

Differences Observed by ASI-6 among users of Alcohol, Cocaine and Opiates

Aim:

To identify the differences in the ASI-6 scores according to main substance of consumption among patients with drug use disorder who were included at the study of adaptation-validation of the Addiction Severity Index 6th version (ASI-6) into Spanish.

Method:

Multicentre, observational, longitudinal, prospective study. 186 substance dependent/abuser individuals were included. Assessments were made with the Spanish ASI-6.

Results:

Main substance of consumption: 57% alcohol, 19.9% cocaine and 19.4% opiates. Men were 77.4% vs. 81.1% vs. 83.3% (p n.s.), mean ages were 47.12 (SD 10.18) vs. 32.62 (SD 8.20) vs. 36.47 (SD 8.04) years (p< 0.001), and 25.5% vs. 64.9% vs. 55.6% were single (p< 0.001). The greatest severity was found in the Alcohol area in the case of alcohol users (56.86) and in the Family/Social Partner Problems area in the case of cocaine and the opiate users (50.43 and 51.22). Alcohol users had statistically significant greater severity than the other two groups in the Alcohol area (56.86 vs. 49.38 vs. 45.17, p< 0.001) and tended to have lower severity in the Legal area than cocaine users (46.78 vs. 48.43, p 0.079).

Conclusions:

Cocaine users were the youngest and used to be single. The ASI-6 only differentiated in the severity of the Alcohol area. Further studies including a higher proportion of cocaine and opiate users are needed.

Physical Health of Patients with Drug use Disorders

Aim:

To describe the physical health profile of patients with drug use disorders who were included in the study of adaptation-validation of the Addiction Severity Index 6th version (ASI-6) into Spanish.

Method:

Multicentre, observational, longitudinal, prospective study. A total of 194 substance dependent/abuser individuals were included. Assessments were made with the Spanish ASI-6.

Results:

Men were 79.9%, mean ages were 41.08 (SD 11.64), 42.3% were single and 87.6% were acute patients. The severity score in the Physical Health area was 44.32 (SD 9.51). The most prevalent diseases were: 25.3% hepatitis, 11.9% had high blood pressure, 8.2% cirrhosis or hepatic disease, 6.7% epilepsy or convulsions and 5.7% tuberculoses. No statistically significant differences were found according to gender. Acute patients had statistically significant higher proportion of pregnant woman (2.3% vs. 0% p< 0.05) and lower proportion of diabetes (3.5% vs. 12.5% p= 0.05).

Conclusions:

Patients with drug use disorders have a mild-moderate severity of physical health. Physical health is not influenced by gender, but it is by the clinical state.