Chapter 29 - Different Effects of Cigarette Smoking on Neuropsychological Performance in Psychiatric Disorders

Abstract

Smoking rates are significantly higher in the psychiatric population than in the general population. However, the prevalence of smokers is not homogeneous across different psychiatric disorders. Exceptionally high smoking rates have been found in patients suffering from schizophrenia (SZ), with high rates in bipolar disorder (BD) and in major depressive disorder (MDD); however, patients with obsessive-compulsive disorder (OCD) smoke less than both patients with other psychiatric disorders and the general population. Distinct cognitive effects of smoking among the different psychiatric populations may in part explain this variation. Some data suggest that smoking may exert beneficial effects on some cognitive functions of subjects with SZ, MDD, or BD, whereas it may have detrimental cognitive effects in healthy subjects and, to a greater extent, in subjects with OCD. In this chapter, we discuss the potential neurobiological mechanisms of smoking. Pharmacological interventions on the cholinergic system and/or cognitive remediation training may contribute to improve cognitive deficits and to promote smoking cessation in individuals with SZ, MDD, and BD.