Smoking, Suicidality and Psychosis: A Systematic Meta-Analysis

Anoop Sankaranarayanan; Serafino Mancuso; Helen Wilding; Suhaila Ghuloum; David Castle

doi:10.1371/journal.pone.0138147

Smoking, Suicidality and Psychosis: A Systematic Meta-Analysis

PLoS One. 2015 Sep 15;10(9):e0138147. doi: 10.1371/journal.pone.0138147. eCollection 2015.

Authors

Anoop Sankaranarayanan¹, Serafino Mancuso², Helen Wilding³, Suhaila Ghuloum⁴, David Castle⁵

Affiliations

¹ Department of Geriatrics, Hamad Medical Corporation, Doha Qatar; Department of Psychiatry, Weil Cornell Medical College, Doha Qatar.
² St Vincent's Hospital, Melbourne, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
³ St Vincent's Hospital, Melbourne, Australia.
⁴ Department of Psychiatry, Weil Cornell Medical College, Doha Qatar; Department of Psychiatry, Hamad Medical Corporation, Doha Qatar.
⁵ St Vincent's Hospital, Melbourne, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Australia; Department of Psychiatry, Australian Catholic University, Melbourne, Australia.

Abstract

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.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Humans
Psychotic Disorders / epidemiology*
Smoking / adverse effects*
Suicide / statistics & numerical data*

Grants and funding

This study was approved funding by the Hamad Medical Corporation Medical Research Centre (Research Proposal # 14486/14) to cover publication charges. None of the authors received any financial benefits, incentives or salary from the funders. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.