Temporal sequencing of nicotine dependence and bipolar disorder in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)
Open accessAbstract
Bipolar disorder (BD) and nicotine dependence (ND) often co-occur. However, the mechanisms underlying this association remain unclear. We aimed to examine, for the first time in a national and representative sample, the magnitude and direction of the temporal relationship between BD and ND; and to compare, among individuals with lifetime ND and BD, the sociodemographic and clinical characteristics of individuals whose onset of ND preceded the onset of BD (ND-prior) with those whose onset of ND followed the onset of BD (BD-prior). The sample included individuals with lifetime BD type I or ND (n = 7958) from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, n = 43093). Survival analyses and logistic regression models were computed to study the temporal association between ND and BD, and to compare ND-prior (n = 135) and BD-prior (n = 386) individuals. We found that ND predicted the onset of BD and BD also predicted the onset of ND. Furthermore, the risk of developing one disorder following the other one was greatest early in the course of illness. Most individuals with lifetime ND and BD were BD-prior (72.6%). BD-prior individuals had an earlier onset of BD and a higher number of manic episodes. By contrast, ND-prior individuals had an earlier onset of both daily smoking and ND, and an increased prevalence of alcohol use disorder. In conclusion, ND and BD predict the development of each other. The phenomenology and course of ND and BD varied significantly depending on which disorder had earlier onset.
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Nicotine dependence is a predictor for developing bipolar disorder.
“Although ND is a predictor for developing BD (19), the genetic association, however, of ND and TUD with BD is less clear.”
From The detrimental effects of smoking on the course and outcome in adults with bipolar disorder—A narrative review (2023) · cites this paper as [19]
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- Authors
- Martínez-Ortega, J. M., Goldstein, B. I., Gutiérrez-Rojas, L., Sala, R., Wang, S., & Blanco, C.
- Affiliations
- Sunnybrook Health Science Centre (CA)
- King's College London (GB)
- New York State Psychiatric Institute (US)
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2013-07
- Volume
- 47
- Issue
- 7
- Pages
- 858-864
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC3674324
- OpenAlex
- W1978488198
- Cited by
- 17
- References
- 39
- Citations by year
- 2026: 2 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 2 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 2
- FWCI
- 0.94
- Type
- journal article
- Language
- en
- Update notices
- erratum (2013-09-01)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institute on Drug Abuse (DA019606, R01DA023973, DA023200, R01DA019606, DA023973, K02DA023200)
- National Cancer Institute (CA133050, R01CA133050)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- nicotine dependence, bipolar disorder, comorbidities, smoking, manic episodes, alcoholism, clinical course, sociodemographic factors
- MeSH terms
- Adolescent, Adult, Age Factors, Bipolar Disorder, Female, Health Surveys, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Tobacco Use Disorder, United States, Proportional Hazards Models, Age of Onset, Alcohol-Related Disorders, Young Adult
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