Smoking and oral symptoms among psychiatric patients

Objectives: To assess smoking habits and oral symptoms of hospitalized psychiatric patients with several known risk factors to oral health such as side-effects of medication. Methods: A pretested questionnaire was delivered to 170 hospitalized psychiatric patients undergoing psychiatric care in Hesperia Psychiatric Hospital, Helsinki, Finland. Both genders were equally represented and the mean age was 40.7 with range 20-65 yrs. The principal diagnosis was schizophrenia in 75%, manic-depressive psychosis in 18% and abuse of drugs and/or alcohol in 16% of the patients studied. Results: Of the patients studied, 22% had no vocational training and 40% were on a disability pension and 19% were unemployed. At the time of the study, 63% of the patients reported regular smoking. Among women and men, 53% and 73% were smokers, respectively. Slightly over half reported smoking 11-20 cigarettes daily. The people on disability pensions reported the most frequent smoking. Dry mouth was reported more frequently (68%) among smoking than non-smoking patients (p=0.02). Among the smokers oral pain (26%) was most clearly felt on the buccal mucosa and at the border of the tongue. Regular smoking was most prevalent (77%) among schizophrenic patients. They also reported high rate of dry mouth (62%). Having dry mouth and eating problems was reported by 44% and 40% of schizophrenic patients, respectively. More than a half of patients using antidepressants (55%) and users of anti-mania medications (53%) had experienced pain throughout the day. Conclusions: Psychiatric patients reported considerably more frequently regular smoking than healthy persons. Smoking psychiatric patients, schizophrenic in particular, with high rate of oral side-effects, should be prioritized when oral health promotional activities are planned.