People with bipolar disorder who smoke appear to have a heightened risk of suicidal behavior — possibly because they are generally prone to impulsive acts, a new study suggests.
Dramatic mood swings, ranging from episodes of debilitating depression to periods of euphoric recklessness, mark bipolar disorder, also known as manic depression. Previous studies have found that bipolar patients who smoke have a higher suicide risk than their nonsmoking counterparts, but the reasons have not been clear.
The new findings suggest that high levels of impulsivity may draw some patients to both smoking and suicidal behavior.
Dr. Michael J. Ostacher and colleagues at Massachusetts General Hospital in Boston found that among 116 bipolar patients they followed, current smokers generally scored higher on a standard measure of suicidal thoughts and behaviors.
Moreover, smokers were more likely to make a suicide attempt during the next nine months, the researchers report in the journal Bipolar Disorders. Five of the 31 smokers in the study (16 percent) attempted suicide during the study period. By comparison, only three of 85 nonsmokers (3.5 percent) attempted suicide during the study.
From a practical standpoint, the findings add more evidence that smoking can be considered a "clinical marker" of higher suicide risk in bipolar patients, the researchers write.
Smoking, in and of itself, may not be a strong predictor of patients' suicide odds, but doctors still can consider it as part of a comprehensive patient assessment, the researchers suggest.
It is unknown whether helping bipolar patients quit smoking would have any effect on their risk of suicidal behavior, they note.
SOURCE: Bipolar Disorders, November 2009.
© 2009 Reuters. All rights reserved. Republication or redistribution of Reuters content, including by caching, framing or similar means, is expressly prohibited without the prior written consent of Reuters.
