title: Smoking, Suicidality and Psychosis: A Systematic Meta-Analysis.
abstract: The aim of this study is to systematically review the literature that explored the association between smoking and suicidal risk among those with serious mental illness and to estimate the risk of suicidal behaviors attributable to smoking among this patient group. Multiple databases (CINAHL, PsycINFO, EMBASE, Informit Health Collection and the Cochrane Library databases) were searched from 1 January 1975 through 15 January 2014, along with references from relevant articles for observational studies that ascertained the association between smoking and suicidal behaviors among patients with psychotic disorders conducted in adult patients. Thirteen studies involving 6813 patients with severe mental illness were included. We found that smoking was significantly associated with suicidality in psychosis with an Odds Ratio of 2.12 (95% CI 1.67-2.7). Smoking is associated with suicidal risk amongst individuals with a severe mental illness; however, it is still unclear whether this represents a true risk factor or a confounder or a mediator via mechanisms, hitherto unknown, needs to be studied further.
authors.affiliation: Department of Geriatrics, Hamad Medical Corporation, Doha Qatar; Department of Psychiatry, Weil Cornell Medical College, Doha Qatar.
authors.forename: Anoop
authors.initials: A
authors.lastname: Sankaranarayanan
authors.affiliation: St Vincent's Hospital, Melbourne, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
authors.forename: Serafino
authors.initials: S
authors.lastname: Mancuso
authors.affiliation: St Vincent's Hospital, Melbourne, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Wilding
authors.affiliation: Department of Psychiatry, Weil Cornell Medical College, Doha Qatar; Department of Psychiatry, Hamad Medical Corporation, Doha Qatar.
authors.forename: Suhaila
authors.initials: S
authors.lastname: Ghuloum
authors.affiliation: St Vincent's Hospital, Melbourne, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Australia; Department of Psychiatry, Australian Catholic University, Melbourne, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Castle
mesh_terms: D006801:Humans; D011618:Psychotic Disorders / Q000453:epidemiology*; D012907:Smoking / Q000009:adverse effects*; D013405:Suicide / Q000706:statistics & numerical data*