title: Current smoking is associated with worse cognitive and adaptive functioning in serious mental illness.
abstract: OBJECTIVE
  Cigarette smoking is highly prevalent among people with bipolar disorder or schizophrenia. Few studies have examined whether smoking history is associated with adaptive functioning among individuals diagnosed with these serious mental illnesses.
  
  
  METHODS
  In a large relatively homogenous cohort of patients with either bipolar disorder (n=363) or schizophrenia (n=400), we investigated the association between cigarette smoking status, intensity, and cumulative exposure and performance on a comprehensive battery of neurocognitive, functional capacity, and informant-rated functional measures. The associations were adjusted for variation in sociodemographic indicators, psychopathologic symptoms, and substance use.
  
  
  RESULTS
  There was an average of 12 pack years of smoking across the sample. People with schizophrenia reported double the rate of current smoking compared to patients with bipolar disorder. Adjusting for demographic covariates, current smokers had worse composite cognitive functioning and poorer functional outcome than past or never smokers. There were no significant differences between never and past smokers, and these effects were evident in both bipolar disorder and schizophrenia.
  
  
  CONCLUSIONS
  Current smokers with either schizophrenia or bipolar disorder evidence worse cognitive and adaptive functioning functional outcome, even when demographic covariates are considered.
authors.affiliation: Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Depp
authors.forename: C R
authors.initials: CR
authors.lastname: Bowie
authors.forename: B T
authors.initials: BT
authors.lastname: Mausbach
authors.forename: P
authors.initials: P
authors.lastname: Wolyniec
authors.forename: M H
authors.initials: MH
authors.lastname: Thornquist
authors.forename: J R
authors.initials: JR
authors.lastname: Luke
authors.forename: J A
authors.initials: JA
authors.lastname: McGrath
authors.forename: A E
authors.initials: AE
authors.lastname: Pulver
authors.forename: T L
authors.initials: TL
authors.lastname: Patterson
authors.forename: P D
authors.initials: PD
authors.lastname: Harvey
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D003071:Cognition; D003430:Cross-Sectional Studies; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications / Q000175:diagnosis; D012565:Schizophrenic Psychology; D057566:Self Report; D012907:Smoking / Q000523:psychology; D012917:Social Adjustment; D014029:Tobacco Use Disorder / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D014481:United States
keywords: Bipolar Disorder; Cognition; Neuropsychology; Nicotine; Psychosis; Schizophrenia