Tobacco craving and suicidal risk in a cohort of subjects with schizophrenia: results from the national FACE-SZ cohort
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Tobacco use is highly prevalent among individuals with schizophrenia and exacerbates craving, a key METHODS: Data were collected from 1769 patients within the FondaMental Expert Centers for Schizophrenia network. Sociodemographic, clinical, addictive, suicidal, and treatment-related variables were analyzed using both univariate and multivariate logistic regression models. Mediation analyses were performed to ensure robust statistical inference. RESULTS: The prevalence of tobacco smoking was 52.8% (n = 878). Higher tobacco craving scores were significantly correlated with increased suicidal ideation (p = 0.004), more frequent suicide attempts (p < 0.001), and higher suicide scores (p < 0.001). In the multivariable analysis, no significant associations were found between craving scores and all suicide outcomes. Regression models confirmed a strong association between tobacco craving and lifetime alcohol use disorder (AUD) (p < 0.001). Mediation analyses showed that AUD does not mediate the craving-suicide relationship (indirect effects p > 0.05). CONCLUSIONS: These findings highlight the complex interplay between clinical severity, substance use, and suicidality in shaping craving levels among patients with schizophrenia. Mediation analyses showed that AUD does not explain the craving-suicide relationship, indicating that these represent separate, parallel risk pathways. Assessment of tobacco craving and comorbid substance use, particularly AUD, is essential when assessing suicide risk. These findings have important implications for suicide prevention and treatment strategies in individuals with schizophrenia and co-occurring substance use disorders.
Source: Psychiatry Research
Authors: Arnaud Tessier, Mélina Fatseas, Yecodji Dansou, Ophélia Godin, Fabrice Berna, Delphine Capdevielle, Cristobal Belmonte, Isabelle Chereau, Pierre-Michel Llorca, Nathalie Coulon, Sylvain Leigner, Thierry D'amato, Romain Rey, Caroline Dubertret, Guillaume Fond, Laurent Boyer, Christine Passerieux, Mathieu Urbach, Baptiste Pignon, Franck Schürhoff, Andrei Szöke, Jasmina Mallet, David Misdrahi, M Andre, C Andrieu-Haller, A Ascarain, F Berna, O Blanc, E Bourguignon, D Capdevielle, M Cléry, I Chereau-Boudet, J Clauss-Kobayashi, N Coulon, R Dassing, JM Dorey, J Dubos, C Dubertret, A Esselin, E Fakra, G Fond, F Gabayet, M Jarroir, D Lacelle, M Leboyer, S Leignier, PM Llorca, J Mallet, E Metairie, T Michel, D Misdrahi, C Passerieux, B Pignon, P Peri, C Portalier, R Rey, C Roman, E Salvat, B Schorr, F Schürhoff, A Szöke, A Tessier, M Urbach, E Very, A Zinetti-Bertschy
Institutions: Centre National de la Recherche Scientifique, Université de Bordeaux, Fondation FondaMental, Institut de Neurosciences Cognitives et Intégratives d’Aquitaine, Centre Hospitalier Charles Perrens, Centre Hospitalier Universitaire de Bordeaux, Inserm, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Centre Hospitalier Universitaire de Montpellier, Université Clermont Auvergne, Lyon 1 Université, Centre de Recherche en Neurosciences de Lyon, Hôpital Louis-Mourier, Sorbonne Paris Cité, Assistance Publique – Hôpitaux de Paris, Institut de Psychiatrie et Neurosciences de Paris, Université Paris Diderot, Université Paris Descartes, Aix-Marseille Université, Aix-Marseille Sciences Economiques, Université Paris-Saclay, Centre de recherche en Epidémiologie et Santé des Populations, Université Paris-Est Créteil, Institut Mondor de Recherche Biomédicale, Université d'Orléans, Centre hospitalier universitaire d'Orléans, Laboratoire Interdisciplinaire pour l’Innovation et la Recherche en Santé d’Orléans
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $4,230
OpenAlex ID: W7130430888