The Journal of Practical Medicine >

2025 , Vol. 41 >Issue 12: 1922 - 1928

DOI: https://doi.org/10.3969/j.issn.1006-5725.2025.12.022

Investigations

Association between smoking status， cognitive function， and personality traits in first⁃episode male patients with schizophrenia

  • Cong LIU ,
  • Fei ZHAI ,
  • Min LI ,
  • Xiaoli ZHANG ,
  • Han SHI ,
  • Ningning GUO ,
  • Changhong WANG
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  • Department of Psychiatry Ⅱ，the Second Affiliated Hospital of Xinxiang Medical University，Xinxiang 453002，Henan，China

Received date: 2025-02-06

  Online published: 2025-07-02

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Abstract

Objective To explore the associations among smoking behavior， cognitive function， and personality traits in first-episode male patients with schizophrenia， thereby providing theoretical underpinnings for individualized treatment strategies in clinical settings. Methods A total of 140 first-episode male inpatients with schizophrenia admitted to the hospital from January 2022 to December 2023 were recruited. According to their smoking behavior， they were categorized into a smoking group （n = 80） and a non-smoking group （n = 60）. Moreover， healthy controls were recruited and classified into a healthy smoking group （n = 62） and a healthy non-smoking group （n = 67） based on their smoking status. The Positive and Negative Syndrome Scale （PANSS） was employed to evaluate psychiatric symptoms in the schizophrenia groups. Nicotine dependence was measured using the Fagerstr?m Test for Nicotine Dependence （FTND） in the two smoking groups. Cognitive function and personality traits were assessed in all participants using the Repeatable Battery for the Assessment of Neuropsychological Status （RBANS） and the Eysenck Personality Questionnaire （EPQ）， respectively. Results Regarding cognitive function， the smoking group among schizophrenia patients demonstrated significantly higher scores than the non-smoking group in immediate memory， attention， and delayed memory （all P < 0.05）. Among schizophrenia patients， FTND scores were moderately negatively correlated with attention and delayed memory （r = -0.552 and -0.657 respectively； both P < 0.001）. Concerning personality traits， smokers had significantly higher scores in neuroticism and psychoticism compared to non-smokers （both P < 0.001）. Both patient groups had significantly lower lie scale scores when contrasted with healthy controls （P < 0.01）， while the healthy smoking group showed significantly higher extraversion scores than the other groups. Conclusions The smoking behavior of male patients during their first episode of schizophrenia exhibits specific characteristics in relation to cognitive performance and personality traits. Smokers demonstrate relatively superior performance in cognitive domains including attention， immediate memory， and delayed memory. However， higher degrees of nicotine dependence are associated with poorer cognitive function， especially in the aspects of attention and delayed memory. Regarding personality， smoking patients display elevated levels of neuroticism and psychoticism. These findings indicate that smoking behavior may be closely associated with cognitive functioning and personality traits， thus meriting clinical attention in the management of schizophrenia.

Key words： first-episode schizophrenia; male; smoking; cognitive function; personality characteristics

Cite this article

Cong LIU , Fei ZHAI , Min LI , Xiaoli ZHANG , Han SHI , Ningning GUO , Changhong WANG . Association between smoking status， cognitive function， and personality traits in first⁃episode male patients with schizophrenia[J]. The Journal of Practical Medicine, 2025 , 41(12) : 1922 -1928 . DOI: 10.3969/j.issn.1006-5725.2025.12.022

References

1 VIERTI? S， TUULIO-HENRIKSSON A， PER?L? J， et al. Activities of daily living， social functioning and their determinants in persons with psychotic disorder［J］. Eur Psychiatry，2012，27（6）：409-415. doi:10.1016/j.eurpsy.2010.12.005
2 刘莎，邓红，于欣，等. 关注精神分裂症认知功能损害的干预与管理［J］. 中华精神科杂志，2024，57（12）：801-807. doi:10.3760/cma.j.cn113661-20240722-00247
3 刘登堂，陆峥，于欣，等. 精神分裂症神经认知评估工具的指引推荐及临床实践应用问题分析［J］. 中华精神科杂志，2024，57（12）：789-795. doi:10.3760/cma.j.cn113661-20240713-00235
4 BOWIE C R， HARVEY P D. Cognitive deficits and functional outcome in schizophrenia［J］. Neuropsychiatr Dis Treat，2006，2（4）：531-536. doi:10.2147/nedt.2006.2.4.531
5 JOSEPH B， NARAYANASWAMY J C， VENKATASUBRAMANIAN G. Insight in schizophrenia： Relationship to positive， negative and neurocognitive dimensions［J］. Indian J Psychol Med，2015，37（1）：5-11. doi:10.4103/0253-7176.150797
6 石川，刘哲宁，于欣，等. 欧洲精神病学协会《精神分裂症认知功能损害评估指引》解读［J］. 中华精神科杂志，2024，57（12）：783-788. doi:10.3760/cma.j.cn113661-20240718-00242
7 MACKENZIE N E， KOWALCHUK C， AGARWAL S M， et al. Antipsychotics， Metabolic Adverse Effects， and Cognitive Function in Schizophrenia［J］. Front Psychiatry，2018，9：622. doi:10.3389/fpsyt.2018.00622
8 KELLY C， MCCREADIE R G. Smoking habits， current symptoms， and premorbid characteristics of schizophrenic patients in Nithsdale， Scotland［J］. Am J Psychiatry，1999，156（11）：1751-1757. doi:10.1176/ajp.156.11.1751
9 CATHER C， PACHAS G N， CIESLAK K M， et al. Achieving Smoking Cessation in Individuals with Schizophrenia： Special Considerations［J］. CNS Drugs，2017，31（6）：471-481. doi:10.1007/s40263-017-0438-8
10 WANG Q， DU W， WANG H， et al. Nicotine's effect on cognition， a friend or foe？［J］. Prog Neuropsychopharmacol Biol Psychiatry，2023，124：110723. doi:10.1016/j.pnpbp.2023.110723
11 SANSONE L， MILANI F， FABRIZI R， et al. Nicotine： From Discovery to Biological Effects［J］. Int J Mol Sci，2023，24（19）：14570. doi:10.3390/ijms241914570
12 RABER J， STAGAMAN K， KASSCHAU K D， et al. Behavioral and Cognitive Performance Following Exposure to Second-Hand Smoke （SHS） from Tobacco Products Associated with Oxidative-Stress-Induced DNA Damage and Repair and Disruption of the Gut Microbiome［J］. Genes （Basel），2023，14（9）：1702. doi:10.3390/genes14091702
13 张晨，方贻儒. 尼古丁乙酰胆碱受体与精神分裂症患者认知功能的研究进展［J］. 中华精神科杂志，2011，44（2）：119-121. doi:10.3760/cma.j.issn.1006-7884.2011.02.017
14 WITTENBERG R E， WOLFMAN S L， DE B M， et al. Nicotinic acetylcholine receptors and nicotine addiction： A brief introduction［J］. Neuropharmacology，2020，177：108256. doi:10.1016/j.neuropharm.2020.108256
15 FOWLER C D， TURNER J R， IMAD D M. Molecular Mechanisms Associated with Nicotine Pharmacology and Dependence［J］. Handb Exp Pharmacol，2020，258：373-393. doi:10.1007/164_2019_252
16 GILBERT D G， STONE B M. Anhedonia in Nicotine Dependence［J］. Curr Top Behav Neurosci， 2022，58：167-184. doi:10.1007/7854_2022_320
17 CASTRO E M， LOTFIPOUR S， LESLIE F M. Nicotine on the developing brain［J］. Pharmacol Res，2023，190：106716. doi:10.1016/j.phrs.2023.106716
18 ZARRINDAST M R， KHAKPAI F. The modulatory role of nicotine on cognitive and non-cognitive functions［J］. Brain Res，2019，1710：92-101. doi:10.1016/j.brainres.2018.12.002
19 MURDAUGH L B， MILIANO C， CHEN I， et al. Effect of chronic vapor nicotine exposure on affective and cognitive behavior in male mice［J］. Sci Rep，2024，14（1）：6646. doi:10.1038/s41598-024-56766-z
20 SCHR?DER R， REUTER M， FA?BENDER K， et al. The role of the SLC6A3 3' UTR VNTR in nicotine effects on cognitive， affective， and motor function［J］. Psychopharmacology （Berl），2022，239（2）：489-507. doi:10.1007/s00213-021-06028-x
21 CHEN J， WAN J， WU Y， et al. The Association Between Personality Traits and Health-Related Quality of Life and the Mediating Role of Smoking： Nationwide Cross-Sectional Study［J］. JMIR Public Health Surveill，2024，10：e51416. doi:10.2196/51416
22 LIEBERMAN J A， PHILLIPS M， GU H， et al. Atypical and conventional antipsychotic drugs in treatment-naive first-episode schizophrenia： A 52-week randomized trial of clozapine vs chlorpromazine［J］. Neuropsychopharmacology，2003，28（5）：995-1003. doi:10.1038/sj.npp.1300157
23 王宇中. 心理卫生评定量表手册［M］. 郑州： 郑州大学出版社，2011.
24 LIM K H， CHEONG Y L， SULAIMAN N， et al. Agreement between the Fagerstr?m test for nicotine dependence （FTND） and the heaviness of smoking index （HSI） for assessing the intensity of nicotine dependence among daily smokers［J］.Tob Induc Dis，2022，20：105. doi:10.18332/tid/155376
25 RANDOLPH C， TIERNEY M C， MOHR E， et al. The Repeatable Battery for the Assessment of Neuropsychological Status （RBANS）： Preliminary clinical validity［J］. J Clin Exp Neuropsychol，1998，20（3）：310-319. doi:10.1076/jcen.20.3.310.823
26 钱铭怡，武国城，朱荣春，等. 艾森克人格问卷简式量表中国版（EPQ-RSC）的修订［J］. 心理学报，2000，32（3）：317-323. doi:doi:10.1007/s11769-000-0010-0
27 王磊，周晓琴. 不同性别慢性精神分裂症患者认知功能障碍的差异［J］. 神经损伤功能重建，2021，16（6）：340-343. doi:10.16780/j.cnki.sjssgncj.20200304
28 WANG D M， XIA L Y， ZHOU H X， et al. Smoking affects the association between cognitive impairment and P50 inhibition defects in patients with chronic schizophrenia： A case-control study［J］. Asian J Psychiatr，2023，79：103391. doi:10.1016/j.ajp.2022.103391
29 HAHN B， ROSS T J， YANG Y， et al. Nicotine enhances visuospatial attention by deactivating areas of the resting brain default network［J］. J Neurosci，2007，27（13）：3477-3489. doi:10.1523/jneurosci.5129-06.2007
30 LAWRENCE N S， ROSS T J， STEIN E A. Cognitive mechanisms of nicotine on visual attention［J］. Neuron，2002，36（3）：539-548. doi:10.1016/s0896-6273(02)01004-8
31 GUPTA T， MITTAL VA. Nicotine usage is associated with elevated processing speed， spatial working memory， and visual learning performance in youth at ultrahigh-risk for psychosis［J］. Psychiatry Res，2014，220（1-2）：687-690. doi:10.1016/j.psychres.2014.07.085
32 唐述龙，王磊，周晓琴. 稳定期男性精神分裂症患者吸烟行为与认知功能的关系［J］. 神经损伤与功能重建，2022，17（3）：141-164. doi:10.16780/j.cnki.sjssgncj.20210247
33 STRAMECKI F， KOTOWICZ K D， PIOTROWSKI P， et al. Assessment of the Association Between Cigarette Smoking and Cognitive Performance in Patients With Schizophrenia-Spectrum Disorders： A Case-Control Study［J］. Front Psychiatry，2018，9：642. doi:10.3389/fpsyt.2018.00642
34 BECK A K， BAKER A L， TODD J. Smoking in schizophrenia： Cognitive impact of nicotine and relationship to smoking motivators［J］. Schizophr Res Cogn，2015，2（1）：26-32. doi:10.1016/j.scog.2014.12.001
35 SAGUD M， MIHALJEVIC PELES A， PIVAC N. Smoking in schizophrenia： Recent findings about an old problem［J］. Curr Opin Psychiatry，2019，32（5）：402-408. doi:10.1097/yco.0000000000000529
36 MA Z， MA Z. Relationship between stable smoking behavior and cognitive function in male schizophrenia patients［J］. J Psychiatr Res，2024，173：296-301. doi:10.1016/j.jpsychires.2024.03.034
37 GAVINI K， YANG E， PARAMESHWARAN K. Developmental nicotine exposure impairs memory and reduces acetylcholine levels in the hippocampus of mice［J］. Brain Res Bull，2021，176：1-7. doi:10.1016/j.brainresbull.2021.07.030
38 PROUD E K， RODRíGUEZ-RUIZ M， GUMMERSON D M， et al. Chronic nicotine exposure induces molecular and transcriptomic endophenotypes associated with mood and anxiety disorders in a cerebral organoid neurodevelopmental model［J］. Front Pharmacol，2024，15：1473213. doi:10.3389/fphar.2024.1473213
39 CAPONNETTO P， POLOSA R， ROBSON D， et al. Tobacco smoking， related harm and motivation to quit smoking in people with schizophrenia spectrum disorders［J］. Health Psychol Res，2020，8（1）：9042. doi:10.4081/hpr.2020.9042
40 CASTLE D， BAKER A L， BONEVSKI B. Editorial： Smoking and Schizophrenia［J］. Front Psychiatry，2019，10：738. doi:10.3389/fpsyt.2019.00738
41 DOCHERTY A R， MULLINS N， ASHLEY-KOCH A E， et al. GWAS Meta-Analysis of Suicide Attempt： Identification of 12 Genome-Wide Significant Loci and Implication of Genetic Risks for Specific Health Factors［J］. Am J Psychiatry，2023，180（10）：723-738. doi:10.1176/appi.ajp.21121266
42 洪叶，田博. 吸烟对精神分裂症的影响的研究进展［J］. 国际精神病学杂志，2019，46（4）：583-585.
43 李思馨. 神经质人格与高职生心理健康发展的关系：特质应对的中介作用［J］. 心理学进展，2023，13（1）：224-231. doi:10.12677/AP.2023.131028
44 孙玉静，张静，宇虹，等. 稳定期精神分裂症患者童年创伤对攻击行为的影响：自尊与心理弹性的链式中介作用研究［J］. 中国全科医学，2023，26（23）：2899-2906. doi:10.12114/j.issn.1007-9572.2023.0030
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