Evidences suggest an association between tobacco and psychosis. However, the reasons why people with psychosis have a higher tendency to smoke than the general population are not yet clear. Recently, Gurillo et al. reported that daily use of tobacco is associated with an increased risk of psychotic disorder and an earlier age of onset of psychotic illness. His study also calculated a significant mean difference in age at onset, expressed in years, and estimated the prevalence of smoking in people with their first episode of psychosis. According to this and other findings, it could be said that the causes of the smoking-schizophrenia association are complex and cannot be explained solely as a result of some aspect of schizophrenia. Thus, new studies in this area are needed, as well as strategies that look for the monitoring of smoking effects in order to reduce it among individuals with schizophrenia.
There are important limitations regarding the Brazilian Custodial Psychiatric Hospitals or Judicial Psychiatric Hospitals situation. They way how they are administrated, as prisons and non as hospitals, could make the health of their patients worst than when they were admitted. These limitations are not just in the hospitals, but on current Laws of the Brazilian Unified Health System. In addition, patients with mental disorders suffer a complex process of stigmatization, prejudice and social reclusion. Despite the existing Laws to the adequate caring and treatment of mentally ill patients and the advances in the psychiatric and mental health field, radical changes should be made on the Judicial Psychiatric Hospitals and on the Judicial and Health Systems in Brazil in order to achieve better results in the life quality of people with mental disorders.
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