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The relationship between nicotine and psychosis
Harriet Quigley1, James H MacCabe2
1Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, SE5 8AF, Denmark Hill, London, UK.
Therapeutic Advances in Psychopharmacology
|July 17, 2019
Summary
Cigarette smoking is linked to psychotic disorders. Recent evidence suggests a bidirectional relationship, possibly due to shared genetic factors influencing both smoking and psychosis risk.
Area of Science:
- Psychiatry
- Genetics
- Epidemiology
Background:
- Cigarette smoking is strongly associated with psychotic disorders like schizophrenia.
- Previous explanations included reverse causation (self-medication, institutionalization) and confounding factors (cannabis, social factors).
- These explanations are insufficient to fully account for the observed association.
Purpose of the Study:
- To review evidence for candidate explanations of the smoking-psychosis link.
- To explore a potential bidirectional relationship between smoking and psychosis risk.
- To investigate the role of shared genetic liability.
Main Methods:
- Review of epidemiological studies.
- Analysis of neuroimaging findings.
- Examination of genetic and preclinical research.
Main Results:
- Traditional explanations like reverse causation and confounding are inadequate.
- Evidence supports a bidirectional relationship between smoking and psychosis.
- Shared genetic liability is a plausible mechanism linking smoking and psychosis.
Conclusions:
- The association between cigarette smoking and psychotic disorders is complex.
- A bidirectional causal link, potentially mediated by shared genetics, is increasingly supported.
- Further research is needed to fully elucidate the underlying mechanisms.
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