Although the majority of patients with schizophrenia smoke, assessment of smoking severity is usually ignored in functional magnetic resonance imaging (fMRI) studies. The aim of this study was to identify whether smoking severity was associated with changes in neural activation in patients with schizophrenia and alcohol use disorder. Seven smokers with schizophrenia and alcohol use disorder who were enrolled in a smoking cessation pilot study underwent fMRI at baseline. Executive function was assessed with the multi-source interference task (MSIT); working memory was assessed using the N-back task. Smoking severity was measured using serum cotinine and nicotine levels and the Fagerstrom Test for Nicotine Dependence. Smoking, alcohol and illicit substance use are major causes of morbidity and mortality in patients with schizophrenia . The prevalence of cigarette smoking is higher in patients with schizophrenia (80%) compared to the general population (20%) and to mentally ill patients (50%) worldwide. The strong association between nicotine dependence and schizophrenia is not understood well. According to the self-medication hypothesis, patients smoke to overcome their neurocognitive impairments, symptom distress and to counteract side effects of neuroleptics.

Smoking Severity and Functional MRI Results In Schizophrenia: A Case-Series

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