Possible effects of smoke-free inpatient units on psychiatric diagnosis and treatment.
BACKGROUND
The author undertook to review the effects of abstinence from smoking and how those effects might influence the diagnosis and treatment of psychiatric disorders when patients are required to temporarily refrain from smoking (e.g., on inpatient wards) or when patients decide to stop smoking permanently.


METHODS
Computerized data bases and reference lists of existing articles were searched for prior publications from three areas: (1) the association of smoking and psychiatric disorders, (2) the effects of nicotine withdrawal, and (3) the role of nicotine in psychiatric disorders.


RESULTS
Withdrawal-induced increases in anxiety, depression, insomnia, irritability, restlessness, and weight and decreases in heart rate could affect the ability to evaluate alcohol/drug withdrawal, anxiety disorders, etc. Withdrawal effects could mimic medication side effects or increase the blood levels of several psychiatric medications. Whether these effects occur frequently or are of clinical magnitude has not been tested in studies of psychiatric patients.


CONCLUSIONS
Psychiatrists should consider the effects of abstinence from smoking when diagnosing and treating patients who enter smoke-free inpatient units or who stop smoking during outpatient treatment.
Hughes
J R
JR
Department of Psychiatry, University of Vermont, Burlington 05401.
D000553:Ambulatory Care; D006760:Hospitalization; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D009538:Nicotine / Q000009:adverse effects; D011567:Psychiatric Department, Hospital; D012907:Smoking / Q000009:adverse effects / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology; D000074606:Smoking Prevention; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000209:etiology / Q000523:psychology
D009538:Nicotine