Objectives Tobacco use is prevalent among people living with bipolar disorder. We examined tobacco use, quit attempts, and tobacco-related attitudes and intentions among 685 individuals with bipolar disorder who smoked ≥ 100 cigarettes in their lifetime. Methods Data were collected online through the website of the Depression and Bipolar Support Alliance a mood disorder peer-support network. Results The sample was 67% female, 67% aged 26 to 50, and 89% Caucasian; 87% were current smokers; 92% of current smokers smoked daily, averaging 19 cigarettes/day (SD=11). The sample began smoking at a mean age of 17 years (SD=6) and smoked a median of 7 years prior to bipolar disorder diagnosis. Among current smokers, 74% expressed a desire to quit; intent to quit smoking was unrelated to current mental health symptoms, χ2(3)= 5.50, p=.139. Only 33% were advised to quit smoking by a mental health provider, 48% reported smoking to treat their mental illness, and 96% believed being mentally healthy was important for quitting. Ex-smokers (13% of sample) had been quit a median of 2.7 years; 48% quit “cold turkey.” Most ex-smokers (64%) were in poor or fair mental health when they quit smoking. At the time of the survey, however, more ex-smokers described their mental health as in recovery than current smokers (57% vs. 40%, χ2(3)=11.12, p=.011). Conclusions Most smokers living with bipolar disorder are interested in quitting. The Internet may be a useful cessation tool for recruiting and potentially treating smokers with bipolar disorder who face special challenges when trying to quit and rarely receive cessation treatment from their mental health providers.

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Objective Describe use of services and self-care strategies by people experiencing suicidal thoughts. Methods Constituents of the Depression and Bipolar Support Alliance (n=611) completed an anonymous online survey regarding experience of suicidal ideation and use of a range of clinical services, community supports, and self-care strategies. Results Mental health providers were the most frequently used and the most favorably rated sources of support. Peer supports were less frequently used, bu also favorably rated. Emergency rooms and crisis lines were used less frequently and were rated less favorably. The most frequently-used self-care strategies included distracting activities, social activities, positive affirmations, exercise, and personal spiritual practices. Conclusions Peer support may be an under-utilized resource for coping with suicidal thoughts. Unfavorable ratings for emergency rooms and crisis clinics may indicate a need to develop more collaborative models of emergency care. Frequent use of spiritual practices suggests greater attention to spirituality in suicide prevention.

Objectives To engage a national advocacy group and local stakeholders for guidance in developing a bipolar disorder biobank through a web-based survey and a community advisory board. Methods The Depression and Bipolar Support Alliance and the Mayo Clinic Bipolar Biobank conducted a national web-based survey inquiring about interest in participating in a biobank (i.e., giving DNA and clinical information). A community advisory board was convened to guide establishment of the biobank and identify key deliverables from the research project and for the community. Results Among 385 survey respondents, funding source (87%), professional opinion (76%), mental health consumer opinion (79%), and return of research results (91%) were believed to be important for considering study participation. Significantly more patients were willing to participate in a biobank managed by a university or clinic (78.2%) than one managed by government (63.4%) or industry (58.2%; both p < 0.001). The nine-member community advisory board expressed interest in research to help predict the likelihood of bipolar disorder developing in a child of an affected parent and which medications to avoid. The advisory board endorsed the use of a comprehension questionnaire to evaluate participants' understanding of the study (e.g., longevity of DNA specimens, right to remove samples, accessing medical records) as a means to strengthen the informed-consent process. Conclusions These national survey and community advisory data support the merit of establishing a biobank to enable studies of disease risk, provided that health records and research results are adequately protected. The goals of earlier diagnosis and individualized treatment of bipolar disorder were endorsed.

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