Abstract

SENDRA-GUTIERREZ, Juan Manuel; CASANOVA PENA, Bernardo  and  VARGAS ARAGON, Martín L.. Smoking and severe mental disorders: conceptualization, theoretical approach and intervention studies. Rev. Asoc. Esp. Neuropsiq. [online]. 2012, vol.32, n.116, pp.707-722. ISSN 2340-2733.  https://dx.doi.org/10.4321/S0211-57352012000400003.

Smoking is a serious health problem in patients with severe mental disorder. This paper is an updated review of its neurophysiological basis and therapeutic approach. There is a known link between nicotinic neurotransmission and schizophrenia without a proposed etiological model. The therapeutic approach of smoking in psychiatric patients requires specific training and smoking units or prepared mental health services. The association with substance abuse, psychiatric drugs, psychiatric comorbidity and lack of professional motivation are limiting factors. Brief intervention uses the health contact to explore smoking status and assess the preparation of the patient to stop smoking. Treatment uses nicotine replacement therapy, antidepressants, nicotine receptor agonist and/or psychosocial interventions. Treatment with bupropion is the most effective and safe, while nicotine replacement therapy and varenicline are also useful. In clinical practice the use of pharmacotherapy and psychotherapy may be the most reasonable option.

Keywords : Smoking; Nicotine dependence; Mental disorders; Schizophrenia and disorders with psychotic features.

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