Association of tobacco smoking with bipolar affective disorder- a comparative cross-sectional study at a tertiary care centre in south India

Abstract

Background: Smokers with psychiatric disorders, most notably those with serious mental illness and substance use disorders tend to present with more severe nicotine dependence and nicotine withdrawal than smokers without these illnesses. The following study aims to explore the correlation of smoking with bipolar affective disorder Setting and design: The comparative cross-sectional study was done in Amrita Institute of Medical Sciences & Research Centre, Kochi, a 1,450-bed hospital for a period of 2 years. Methods and materials: Seventy subjects with Bipolar affective Disorder who were in remission for at least two months and Seventy subjects who were relatives of paediatric outpatients were included in the study and control group, respectively. Clinical variables were assessed, and Hamilton depression rating scale, Young mania rating scale and Fagerstorm nicotine rating scale were administered to the subjects. Results: In this study, 52.9% of subjects with bipolar disorder were found to be smokers, and 51.4% of the normal population were smokers. No significant association was observed between bipolar affective disorder, and smoking tobacco, however, a significant correlation was found between smoking status and the total number of episodes of the disorder, psychotic episodes and suicide attempts. Conclusion: There appears to be a relationship between smoking tobacco and certain clinical features of bipolar affective disorder. It is possibly a bidirectional relation between these two disorders.