title: Smoking is associated with greater symptom load in bipolar disorder patients.
abstract: BACKGROUND
  Individuals with mental illness have a higher prevalence of smoking than those without a mental illness. Nicotine has several effects on mood and cognition. After many studies, the nature of the effect of smoking on mental illness is not clear.
  
  
  METHODS
  We performed a cross-sectional study of smoking status and symptom load in an outpatient bipolar disorder population. Data were collected and analyzed from 134 outpatients regarding smoking status and symptom profile and severity using the Rapid Psychiatric Interview Data scale.
  
  
  RESULTS
  Smokers had more severe anxiety symptoms (5.2 ± 7.6 vs 2.2 ± 3.3, z = 3.8, P = .0001), depressive symptoms (9.0 ± 9.6 vs 6.5 ± 8.1, z = 3.2, P = .0015), and manic symptoms (3.0 ± 4.2 vs 1.5 ± 2.9, z = 2.1, P = .04) than nonsmokers.
  
  
  CONCLUSIONS
  Smokers with bipolar disorder carry a greater symptom burden than nonsmokers. However, this is an associational study, and the true nature of the relationship is not clear.
authors.affiliation: Mood Disorders Research Program, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY 40202, USA.
authors.forename: Mohamedlatif
authors.initials: M
authors.lastname: Saiyad
authors.forename: Rif S
authors.initials: RS
authors.lastname: El-Mallakh
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology*; D002642:Chick Embryo; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology*