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publicado em 02/02/2013 às 11h11:00
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Smoking is more common in patients with more severe mental disorder

Expert warns that health professionals should know better to make the problem more effective interventions

 
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Foto: Marcos Santos/USP imagens
Study revealed different ways of smoking to the mentally ill.
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Study revealed different ways of smoking to the mentally ill.

Research with 270 hospitalized patients with mental disorders in general hospitals revealed that 35.6% were smokers, number higher than the national average, which is 17.6%. The study, conducted by the School of Nursing of Ribeirão Preto (EERP) USP, also shows that smoking is more common in patients with more severe disorders such as schizophrenia. According to the nurse Renata Marques de Oliveira, author of the study, health professionals should know better interventions for the problem that lead to smoking cessation and prevent nonsmokers develop dependence.

Initially were interviewed through structured questions of identification, 270 patients with mental disorders, regardless of whether or not to use tobacco, hospitalized in the psychiatric ward of the University Hospital of Marilia (São Paulo). Of this total, 96 were identified smokers (35.6%), which, in addition to answering the questions structured identification, reported through the open questions the meaning of smoking in your life. The number of smokers is higher than the national average, estimated at 17.6% by the Brazilian Institute of Geography and Statistics (IBGE). The study also shows that 84.4% of patients identified as smokers have tried to quit smoking at least once in life, but the majority (67.7%) did not receive any professional support, says Renata.

Smoking is more common among people with severe mental disorders (schizophrenia, mood and personality) and is associated with greater time since diagnosis, number of hospitalizations, use of alcohol and illicit substances, tells the nurse. The severity of nicotine dependence is associated with schizophrenia spectrum disorders, older age and physical comorbidities.

According to Renata, the study revealed different ways of smoking to the mentally ill. Ente they are pleased, distraction, self-medication of psychiatric symptoms, relief of side effects of medications, facilitation of social interactions, relieve loneliness, self-control, safety and security, said. It is also assigned the role of providing aid to forget the problems and address the non-acceptance of their limitations, self-destruction (for patients hospitalized after suicide attempt), companionship and meaning to life.

In fact, when the schizophrenic smokes it reduces the dosage of medications. As a result, psychiatric medications fail to provide the desired therapeutic effect

<b> Smoking and schizophrenia </ b>

The research identified that there is a difference in the sense that schizophrenics attributed to smoking as compared to those of other disorders. According to a statement from the patients themselves, the cigarette is something irreplaceable, a refuge for the problems arising from schizophrenia, it is as necessary as breathing. The work was directed by Professor Antonia Regina Ferreira Furegato, the EERP, funded by the National Council for Scientific and Technological Development (CNPq). The study is described in dissertation submitted in EERP in September 2012.

Renata shows that an aspect discussed in the literature and reported by respondents is the relief of side effects of psychiatric medications derived from smoking. Despite this apparent advantage, it should be considered that the relief of side effects occurs due to reduction of about one third of the concentration of medication in the bloodstream stresses. In fact, when the schizophrenic smokes it reduces the dosage of medications. As a result, psychiatric medications fail to provide the desired therapeutic effect and the disorder is aggravated.

According to Renata, smoking in mental disorders also involves a matter of historical and cultural psychiatric services for many years used the cigarette as one of care tools to help control the behavior of patients, encouraging participation in therapeutic activities and facilitate socializing. Therefore, it is a complex issue that involves historical, cultural, physiological, psychological and social. The nurse points out that search results will serve as a basis for developing intervention programs to smoking.

'We must empower profisisonais health to deal with the problem and listen to the patient to understand the meaning that smoking has on your life and investigate their motivation to quit smoking, recommends. The nurse also advises that all efforts should be made to prevent patients from starting to smoke in the hospital. For many of them start smoking may be no going back. While recognizing the right of autonomy of the patient at the time of the outbreak psychiatric patient is unable to decide whether or not to start smoking.

Source: USP
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Smoking    mental disorder    schizophrenia    USP    University of São Paulo    School of Nursing of Ribeirão Preto   
Comments:
Comment
Luiza Santos
posted on:
04/02/2013 00:48:23
É preciso investimento do governo federal na capacitação para os profissionais na área de Periodontia. Sou Cirurgiã-Dentista trabalho na Estratégia Saúde da Família em Teresina desenvolvi um trabalho de Promoção de Saúde Bucal no CAPS II em Teresina e sei da necessidade de realizar tratamento periodontal nos pacientes com transtorno mental.
Luiza Santos
posted on:
04/02/2013 00:48:17
É preciso investimento do governo federal na capacitação para os profissionais na área de Periodontia. Sou Cirurgiã-Dentista trabalho na Estratégia Saúde da Família em Teresina desenvolvi um trabalho de Promoção de Saúde Bucal no CAPS II em Teresina e sei da necessidade de realizar tratamento periodontal nos pacientes com transtorno mental.
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