Cigarette smoking is associated with suicidality in bipolar disorder

  1. Michael J Ostacher1,2,
  2. Richard T LeBeau1,
  3. Roy H Perlis1,2,
  4. Andrew A Nierenberg1,2,
  5. Hannah G Lund3,
  6. Samantha J Moshier1,
  7. Gary S Sachs1,2,
  8. Naomi M Simon1,2

Article first published online: 14 OCT 2009

DOI: 10.1111/j.1399-5618.2009.00744.x

Issue

Bipolar Disorders

Bipolar Disorders

Volume 11, Issue 7, pages 766–771, November 2009

Additional Information

How to Cite

Ostacher, M. J., LeBeau, R. T., Perlis, R. H., Nierenberg, A. A., Lund, H. G., Moshier, S. J., Sachs, G. S. and Simon, N. M. (2009), Cigarette smoking is associated with suicidality in bipolar disorder. Bipolar Disorders, 11: 766–771. doi: 10.1111/j.1399-5618.2009.00744.x

Author Information

  1. 1

    Massachusetts General Hospital

  2. 2

    Harvard Medical School, Boston, MA

  3. 3

    Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA

*Corresponding author: Michael J. Ostacher, M.D., M.P.H. Bipolar Clinic and Research Program Massachusetts General Hospital 50 Staniford Street, Suite 580 Boston, MA 02114, USA Fax: (617) 726-6768 E-mail: mostacher@partners.org

Publication History

  1. Issue published online: 14 OCT 2009
  2. Article first published online: 14 OCT 2009
  3. Received 21 November 2008, revised and accepted for publication 5 June 2009

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (142K)

Keywords:

  • bipolar disorder;
  • impulsivity;
  • nicotine;
  • smoking;
  • substance abuse;
  • suicidality

Objectives:  Cigarette smoking in individuals with bipolar disorder has been associated with suicidal behavior, although the precise relationship between the two remains unclear.

Methods:  In this prospective observational study of 116 individuals with bipolar disorder, we examined the association between smoking and suicidality as measured by Linehan’s Suicide Behaviors Questionnaire (SBQ) and prospective suicide attempts over a nine-month period. Impulsivity was measured by the Barratt Impulsiveness Scale.

Results:  Smoking was associated with higher baseline SBQ scores in univariate and adjusted analyses, but was not significant after statistical adjustment for impulsivity in a regression model. A higher proportion of smokers at baseline made a suicide attempt during the follow-up period (5/31, 16.1%) compared to nonsmokers (3/85, 3.5%); p = 0.031, odds ratio = 5.25 (95% confidence interval: 1.2–23.5). Smoking at baseline also significantly predicted higher SBQ score at nine months.

Conclusions:  In this study, current cigarette smoking was a predictor of current and nine-month suicidal ideation and behavior in bipolar disorder, and it is likely that impulsivity accounts for some of this relationship.

View Full Article (HTML) Get PDF (142K)