title: Nicotine dependence and psychosis in Bipolar disorder and Schizoaffective disorder, Bipolar type.
abstract: Patients with Bipolar disorder smoke more than the general population. Smoking negatively impacts mortality and clinical course in Bipolar disorder patients. Prior studies have shown contradictory results regarding the impact of psychosis on smoking behavior in Bipolar disorder. We analyzed a large sample of Bipolar disorder and Schizoaffective disorder, Bipolar Type patients and predicted those with a history of psychosis would be more likely to be nicotine dependent. Data from subjects and controls were collected from the Genomic Psychiatry Cohort (GPC). Subjects were diagnosed with Bipolar disorder without psychosis (N = 610), Bipolar disorder with psychosis (N = 1544). Participants were classified with or without nicotine dependence. Diagnostic groups were compared to controls (N = 10065) using logistic regression. Among smokers (N = 6157), those with Bipolar disorder had an increased risk of nicotine dependence (OR = 2.5; P < 0.0001). Patients with Bipolar disorder with psychosis were more likely to be dependent than Bipolar disorder patients without psychosis (OR = 1.3; P = 0.03). Schizoaffective disorder, Bipolar Type patients had more risk of nicotine dependence when compared to Bipolar disorder patients with or without psychosis (OR = 1.2; P = 0.02). Bipolar disorder patients experiencing more severity of psychosis have more risk of nicotine dependence. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, California.
authors.forename: Elena
authors.initials: E
authors.lastname: Estrada
authors.affiliation: Department of Psychiatry, Washington University in St. Louis, Missouri.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Hartz
authors.affiliation: Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, California.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Tran
authors.affiliation: Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, California.
authors.forename: Donald M
authors.initials: DM
authors.lastname: Hilty
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York.
authors.forename: Pamela
authors.initials: P
authors.lastname: Sklar
authors.affiliation: Department of Psychiatry, Harvard University, Boston, Massachusetts.
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Smoller
authors.affiliation: Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, California.
authors.forename: Michele T
authors.initials: MT
authors.lastname: Pato
authors.affiliation: Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, California.
authors.forename: Carlos N
authors.initials: CN
authors.lastname: Pato
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000523:psychology*
keywords: cigarettes; severe mental illness; smoking