A prospective study of the impact of smoking on outcomes in bipolar and schizoaffective disorder

Department of Clinical and Biomedical Sciences, Barwon Health, The University of Melbourne, PO Box 281, Geelong VIC 3220, Australia.
Comprehensive psychiatry (Impact Factor: 2.26). 09/2010; 51(5):504-9. DOI: 10.1016/j.comppsych.2009.12.001
Source: PubMed

ABSTRACT Tobacco smoking is more prevalent among people with mental illnesses, including bipolar disorder, than in the general community. Most data are cross-sectional, and there are no prospective trials examining the relationship of smoking to outcome in bipolar disorder. The impact of tobacco smoking on mental health outcomes was investigated in a 24-month, naturalistic, longitudinal study of 240 people with bipolar disorder or schizoaffective disorder.
Participants were interviewed and data recorded by trained study clinicians at 9 interviews during the study period.
Comparisons were made between participants who smoked daily (n = 122) and the remaining study participants (n = 117). During the 24-month study period, the daily smokers had poorer scores on the Clinical Global Impressions-Depression (P = .034) and Clinical Global Impressions-Overall Bipolar (P = .026) scales and had lengthier stays in hospital (P = .012), compared with nonsmokers.
Smoking status was determined by self-report. Nicotine dependence was not measured.
These findings suggest that smoking is associated with poorer mental health outcomes in bipolar and schizoaffective disorder.

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    • "However, there is a high rate of tobacco consumption among individuals that suffer from mental disorders such as, major depression disorder (MDD), schizophrenia , and post-traumatic stress disorder (PTSD; Leonard et al., 2001; Weaver and Etzel, 2003; Thorndike et al., 2006; Buggia-Prevot et al., 2008; Aubin et al., 2012). The idea that tobacco consumption in these populations is a form of self-medication is controversial and some evidence suggests that smoking is associated with poorer mental health outcomes in some mental disorders such as, bipolar and schizoaffective disorder (Dodd et al., 2010). The desire to identify the component of tobacco that may explain this correlation has encouraged the study of the mental effect(s) of nicotine [3-(1-methyl-2-pyrrolidinyl) pyridine], an alkaloid that is present in tobacco leaves, over the psychiatric symptoms. "
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    • "In mood and psychotic disorders, alcohol abuse and dependence is associated with poorer functioning and higher rates of suicide attempts (Cardoso et al., 2008; Oquendo et al., 2010). Even smoking appears associated with poorer outcomes, particularly in mood disorders (Berk et al., 2008; Pasco et al., 2008; Ashton et al., 2010; Dodd et al., 2010; Mathews et al., 2010). It is therefore important that secondary causes of disability and treatment resistance such as substance abuse are actively managed. "
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