title: Effects of chewing betel nut (Areca catechu) on the symptoms of people with schizophrenia in Palau, Micronesia.
abstract: BACKGROUND
  Although millions of people with schizophrenia live in betel chewing regions, the effects of betel chewing on their symptoms are unknown. Betel nut alkaloids include potent muscarinic cholinomimetics: recent research suggests that these agents may be therapeutic in schizophrenia.
  
  
  OBJECTIVE
  To compare the primary and extrapyramidal symptom profiles and substance-using habits of betel chewing v. non-chewing people with schizophrenia.
  
  
  METHODS
  A cross-sectional study of 70 people with schizophrenia. Symptom ratings measured by the Positive and Negative Syndrome Scale (PANSS) and Extrapyramidal Symptom Rating Scale (ESRS), and demographic and substance-use data, were compared for 40 chewers and 30 non-chewers of betel nut.
  
  
  RESULTS
  Betel chewers with schizophrenia scored significantly lower on the positive (P = 0.001) and negative (P = 0.002) sub-scales of the PANSS than did non-chewers. There were no significant differences in extrapyramidal symptoms or tardive dyskinesia.
  
  
  CONCLUSIONS
  Betel chewing is associated with milder symptomatology and avoidance of more harmful recreational drugs. These initial results indicate that longitudinal research is merited.
authors.affiliation: Department of Anthropology, University of Auckland, New Zealand.
authors.forename: R J
authors.initials: RJ
authors.lastname: Sullivan
authors.forename: J S
authors.initials: JS
authors.lastname: Allen
authors.forename: C
authors.initials: C
authors.lastname: Otto
authors.forename: J
authors.initials: J
authors.lastname: Tiobech
authors.forename: K
authors.initials: K
authors.lastname: Nero
mesh_terms: D000328:Adult; D001114:Areca / Q000737:chemistry*; D001115:Arecoline / Q000627:therapeutic use*; D018679:Cholinergic Agonists / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D008849:Micronesia; D010946:Plants, Medicinal; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy*; D019966:Substance-Related Disorders / Q000150:complications
chemical_list: D018679:Cholinergic Agonists; D011619:Psychotropic Drugs; D001115:Arecoline