Nicotine dependence is associated with depression and childhood trauma in smokers with schizophrenia: results from the FACE-SZ dataset

• Published in: European archives of psychiatry and clinical neuroscience 2017-09, Vol.267 (6), p.567-577
• Main Authors: Rey, Romain, D’Amato, Thierry, Boyer, Laurent, Brunel, Lore, Aouizerate, Bruno, Berna, Fabrice, Capdevielle, Delphine, Chereau, Isabelle, Chesnoy-Servanin, Gabrielle, Denizot, Hélène, Dorey, Jean-Michel, Dubertret, Caroline, Dubreucq, Julien, Faget, Catherine, Gabayet, Franck, Lancon, Christophe, Mallet, Jasmina, Misdrahi, David, Passerieux, Christine, Schandrin, Aurélie, Schürhoff, Franck, Urbach, Mathieu, Vidailhet, Pierre, Llorca, Pierre-Michel, Fond, Guillaume
• Format: Article
• Language: English
• Subjects: Adverse childhood experiences; Antidepressants; Childhood; Children; Drug addiction; Drug dependence; Gender; Human health and pathology; Life Sciences; Medicine; Medicine & Public Health; Mental depression; Mental disorders; Neurons and Cognition; Neurosciences; Nicotine; Original Paper; Psychiatrics and mental health; Psychiatry; Schizophrenia; Smoking cessation; Trauma
• ISSN: 0940-1334; 1433-8491
• DOI: 10.1007/s00406-017-0779-9

In a perspective of personalized care for smoking cessation, a better clinical characterization of smokers with schizophrenia (SZ) is needed. The objective of this study was to determine the clinical characteristics of SZ smokers with severe nicotine (NIC) dependence. 240 stabilized community-dwelling SZ smokers (mean age = 31.9 years, 80.4% male gender) were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia and assessed with validated scales. Severe NIC dependence was defined by a Fagerstrom questionnaire score ≥ 7. Depression was defined by a Calgary score ≥ 6. Childhood trauma was self-reported by the Childhood Trauma Questionnaire score (CTQ). Ongoing psychotropic treatment was recorded. Severe NIC dependence was identified in 83 subjects (34.6%), depression in 60 (26.3%). 44 (22.3%) subjects were treated by antidepressants. In a multivariate model, severe NIC dependence remained associated with depression (OR = 3.2, p  = 0.006), male gender (OR = 4.5, p  = 0.009) and more slightly with childhood trauma (OR = 1.03, p  = 0.044), independently of socio-demographic characteristics, psychotic symptoms severity, psychotropic treatments and alcohol disorder. NIC dependence was independently and strongly associated with, respectively, depression and male gender in schizophrenia, and only slightly with history of childhood trauma. Based on these results, the care of both nicotine dependence and depression should be evaluated for an effective smoking cessation intervention in schizophrenia.