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Betel use and schizophrenia

Faculty of Medicine, University of Kelaniya, PO Box 6, Thalagolla Road, Ragama, Sri Lanka

EDITED BY KHALIDA ISMAIL

The Scottish Comorbidity Study Group has highlighted again the problem of greater use of drugs and alcohol, and especially tobacco, among patients with schizophrenia (McCreadie et al, 2002). An underrecognised comorbidity, however, especially in developing countries, is that of chewing betel nut (Areca catechu), along with the betel leaf (Piper betle) and lime.

In a preliminary study conducted in the North Colombo Teaching Hospital, Sri Lanka, we observed that a higher proportion of patients with schizophrenia chewed betel compared with control subjects. The frequency of chewing betel was also higher among the patients with schizophrenia. A recent study from Micronesia (Sullivan et al, 2000) has shown that betel chewing may in fact have a beneficial effect on patients with schizophrenia in terms of reducing both positive and negative symptoms. They postulate that the muscarinic agonist action of the betel nut alkaloid, arecoline, may provide an explanation.

However, betel chewing is an important risk factor for oro-pharyngeal carcinoma, and contributes significantly to oral health-related morbidity and mortality (Trivedy et al, 2002). Thus, the dual diagnosis of schizophrenia and betel chewing should not be missed, and services to address this problem should receive priority in many developing countries.

REFERENCES

McCreadie, R. G. on behalf of the Scottish Comorbidity Study Group (2002) Use of drugs, alcohol and tobacco by people with schizophrenia: case—control study. British Journal of Psychiatry, 181, 321-325.[Abstract/Free Full Text]

Sullivan, R. J., Allen, J. S., Otto, C., et al (2000) Effects of chewing betel nut (Areca catechu) on the symptoms of people with schizophrenia in Palau, Micronesia. British Journal of Psychiatry, 177, 174-178.[Abstract/Free Full Text]

Trivedy, C. R., Craig, G. & Warnakulasuriya, S. (2002) The oral health consequences of chewing areca nut. Addiction Biology, 7, 115-125.[Medline]

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Kuruppuarachchi, K. A. L. A. Articles by Williams, S. S. Search for Related Content PubMed PubMed Citation Articles by Kuruppuarachchi, K. A. L. A. Articles by Williams, S. S.