Smoking Habits in Bipolar and Schizophrenic Outpatients in Southern Israel
J Clin Psychiatry 2001;62(4):269-272
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Background: Although rates of cigarette smoking
have been found to be higher in schizophrenic and depressed
patients than in the general population, data regarding rates in
bipolar patients are limited. This study further examines the
relationship between bipolar disorder and smoking and compares
the rate of smoking in bipolar disorder patients with rates in
schizophrenic patients and in the general population.
Method: Seventy bipolar patients and 64
schizophrenic patients (diagnosed using DSM-IV criteria) treated
at the largest specialized public bipolar and schizophrenia
clinics in southern Israel were interviewed regarding their
smoking habits. The interview included a questionnaire relating
to personal information, past and present smoking, and drug abuse
and the Fagerstrom scale for nicotine dependence. Data from these
patients were also compared with data from the general Israeli
Results: Data indicate that the rate of smoking
does not appear to differ between bipolar (43.0%) and
schizophrenic (45.0%) patients, whereas the rate for both patient
groups is higher than that for the general Israeli population
(27.5%). Smoking intensity was not found to be different between
the 2 groups of patients.
Conclusion: Smoking in patients with
schizophrenia was suggested to be related to nicotine cholinergic
dysfunction, but this suggestion cannot explain the equally high
rates of smoking in bipolar patients. Schizophrenia, bipolar
disorder, and smoking may all be related to dopamine
transmission, and, therefore, dopaminergic interactions may
provide a better explanation for the results.