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Smoking, Suicidality and Psychosis: A Systematic Meta-Analysis
Anoop Sankaranarayanan1, Serafino Mancuso2, Helen Wilding3
1Department of Geriatrics, Hamad Medical Corporation, Doha Qatar; Department of Psychiatry, Weil Cornell Medical College, Doha Qatar.
Plos One
|September 16, 2015
Summary
Smoking significantly increases suicidal risk in individuals with serious mental illness. Further research is needed to understand if smoking is a direct cause or a contributing factor to suicidality in this population.
Area of Science:
- Psychiatry
- Public Health
- Epidemiology
Background:
- Serious mental illness (SMI) is associated with higher rates of suicidal behaviors.
- Smoking is prevalent in individuals with SMI, but its role in suicidality requires clarification.
Purpose of the Study:
- To systematically review and synthesize evidence on the association between smoking and suicidal risk in patients with SMI.
- To estimate the risk of suicidal behaviors attributable to smoking in this vulnerable group.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (CINAHL, PsycINFO, EMBASE, Informit Health Collection, Cochrane Library) from 1975 to 2014.
- Included observational studies that examined the link between smoking and suicidal behaviors in adult patients with psychotic disorders.
- A meta-analysis was performed on 13 studies involving 6813 patients.
Main Results:
- Smoking was significantly associated with increased suicidality in patients with psychosis.
- The pooled Odds Ratio for suicidality among smokers with psychosis was 2.12 (95% CI 1.67-2.7).
Conclusions:
- Smoking is a significant risk factor for suicidal behaviors in individuals with severe mental illness.
- Further research is necessary to elucidate the mechanisms underlying this association, distinguishing between direct causality, confounding, or mediation.
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