Smoking, Suicidality and Psychosis: A Systematic Meta-Analysis
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The aim of this study is to systematically review the literature that explored the association between smoking and suicidal risk among those with serious mental illness and to estimate the risk of suicidal behaviors attributable to smoking among this patient group. Multiple databases (CINAHL, PsycINFO, EMBASE, Informit Health Collection and the Cochrane Library databases) were searched from 1 January 1975 through 15 January 2014, along with references from relevant articles for observational studies that ascertained the association between smoking and suicidal behaviors among patients with psychotic disorders conducted in adult patients. Thirteen studies involving 6813 patients with severe mental illness were included. We found that smoking was significantly associated with suicidality in psychosis with an Odds Ratio of 2.12 (95% CI 1.67-2.7). Smoking is associated with suicidal risk amongst individuals with a severe mental illness; however, it is still unclear whether this represents a true risk factor or a confounder or a mediator via mechanisms, hitherto unknown, needs to be studied further.
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Smoking is associated with heightened prospective risk of mental disorders, earlier age of onset, and adverse outcomes in those living with mental illness.
“These findings are in line with multiple meta-analyses showing that smoking is associated with a heightened prospective risk of mental disorders, earlier age of onset, and adverse outcomes in those living with mental illness 53,54 .”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [54]
The Discussion reports that smoking is associated with suicidal behaviours among people with severe mental illness (pooled odds ratio 2.12), supporting a specific adverse outcome. It also says previous research suggests smoking might increase the risk of mental illness, but does not establish the claimed heightened prospective risk. The Introduction notes that smoking can predate psychosis; it does not say smoking is associated with an earlier age of onset. (LLM, conf=0.86)
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High nicotine dependence is a factor in the risk of suicide in bipolar disorder patients
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Advances in Behavioural Pharmacology
DEWS, P. B., & Thompson, T. I. (2013) · Cited by 2 · see citing works
Flagged first, then by citations
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Cited by
Sorted by citations
Firth, J., Solmi, M., Wootton, R. E., Vancampfort, D., Schuch, F. B., Hoare, E., Gilbody, S., Torous, J., Teasdale, S. B., Jackson, S. E., et al. (2020) · World Psychiatry · doi:10.1002/wps.20773 · Cited by 1,148 · see citing works
- Authors
- Sankaranarayanan, A., Mancuso, S., Wilding, H., Ghuloum, S., & Castle, D.
- Affiliations
- Weill Cornell Medical College in Qatar (QA)
- The University of Melbourne (AU)
- St Vincent's Hospital Melbourne (AU)
- Corresponding author
- Sankaranarayanan, Anoop
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2015-09-15
- Volume
- 10
- Issue
- 9
- Pages
- e0138147
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4570823
- OpenAlex
- W2219115282
- Cited by
- 24
- References
- 102
- Citations by year
- 2026: 1 · 2024: 5 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 5 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 3 · 2015: 1
- FWCI
- 2.48
- Type
- journal article
- Language
- en
- Update notices
- correction (2015-10-15)
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- Hamad Medical Corporation
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- smoking, suicidality, psychosis, severe mental illness, suicide risk, attributable risk, confounding, mediation, tobacco use
- MeSH terms
- Humans, Psychotic Disorders, Smoking, Suicide
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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