Smoking behavior in persons with a schizophrenia-spectrum disorder: a qualitative investigation of the transtheoretical model

Smoking rates among persons with schizophrenia are up to three times the rates of the general US population, and research has shown that it is difficult to design cessation programs for people with schizophrenia that take into account their various cognitive and social deficits. More research is needed on the attitudes and priorities of people with schizophrenia in order to design and implement effective smoking cessation programs. Additionally, more research should be conducted with first-episode psychosis and chronic schizophrenia patients to investigate possible differences between these two groups. The purpose of this study, conducted in Atlanta, USA, was to use qualitative methodology to assess the Transtheoretical Model (TTM) in the context of smoking behavior in a sample of participants with schizophrenia-spectrum disorders. Data were obtained via interviews with 12 participants with either first-episode or chronic schizophrenia-spectrum disorders who smoked cigarettes. Differences between the two subsets of the sample were assessed. Results clustered into the following prevalent themes: (1) pros and cons of smoking; (2) beliefs about smoking cessation; (3) external influences on smoking and quitting; and (4) negative attitudes toward nicotine replacement therapies (NRT). Findings indicate that the majority of participants were in the precontemplation stage of quitting smoking, and that the primary advantages of smoking for this sample were relief from anxiety and negative symptoms. Important differences were found between chronic and first-episode participants in the areas of readiness-to-quit and beliefs about smoking cessation. Other findings indicate a lack of cessation programs offered to this sample, and overall negative attitudes toward NRT. Future interventions should take into account the reported pros and cons of smoking in this population, as well as other beliefs and attitudes regarding smoking behavior.First-episode psychosis Schizophrenia Smoking cessation Transtheoretical model USA

Prodromal and Autistic Symptoms in Schizotypal Personality Disorder and 22q11.2 Deletion Syndrome

Despite clear diagnostic distinctions, schizophrenia and autism share symptoms on several dimensions. Recent research has suggested the two disorders overlap in etiology, particularly with respect to inherited and noninherited genetic factors. Studying the relationship between psychotic-like and autistic-like symptoms in risk groups such as 22q11 deletion syndrome (22q11DS) and schizotypal personality disorder (SPD) has the potential to shed light on such etiologic factors; thus, the current study examined prodromal symptoms and autistic features in samples of 22q11DS and SPD subjects using standardized diagnostic measures, including the Structured Interview for Prodromal Symptoms (SIPS) and the Autism Diagnostic Inventory—Revised (ADI-R). Results showed that SPD subjects manifested significantly more severe childhood and current social as well as stereotypic autistic features, as well as more severe positive prodromal symptoms. The two groups did not differ on negative, disorganized, or general prodromal symptoms, but were distinguishable based on correlations between prodromal and autistic features; the relationships between childhood autistic features and current prodromal symptoms were stronger for the SPD group. The results suggest that childhood autistic features are less continuous with subsequent prodromal signs in 22q11DS patients relative to those with SPD, and the findings highlight the importance of studying the overlap in diagnostic phenomenology in groups at risk for developing psychosis and/or autism