A systematic review of tobacco use in first-episode psychosis

Background and objectives: The prevalence of tobacco use in patients with first-episode psychosis is elevated, higher than in the general population. Classically studies in first-episode psychosis are few with most current studies referring to patients with chronic psychotic disorders. However, in recent years there has been increasing interest in understanding the concrete origin of the relationship between tobacco use and the first-episode psychosis. This study provides a systematic review of current research on the relationship between tobacco use and first-episode psychosis. Methods: A comprehensive systematic review of electronic databases PubMed and Web of Science was conducted. Articles were included if they mentioned the relationship between tobacco use and first-episode psychosis. Ten original articles were selected. Results: The prevalence of tobacco use in first-episode psychosis patients was high, ranging from 36.7% to 72%. Results are divergent regarding gender differences and tobacco use in first-episode psychosis. Some studies have found that tobacco-using first-episode psychosis patients were younger than non-tobacco-using patients. Three hypotheses have been proposed to explain the relationship between tobacco use and first-episode psychosis: 1) tobacco smoking as a potential risk factor for first-episode psychosis; 2) nicotine use as a form of self-medication treatment; and 3) tobacco use as a marker for greater illness severity in first-episode psychosis. Conclusions: This review demonstrates that the relationship between tobacco use and the first episode psychosis seems clear. Primary and secondary preventive strategies regarding tobacco use would be useful for first-episode psychosis patients, and included in early intervention in psychosis teams. (C) 2020 Asociacion Universitaria de Zaragoza para el Progreso de la Psiquiatria y la Salud Mental. Published by Elsevier Espana, S.L.U. All rights reserved.