Tobacco smoking and other substance use disorders associated with recurrent suicide attempts in bipolar disorder

Icick, Romain; Melle, Ingrid; Étain, Bruno; Ringen, Petter Andreas; Aminoff, Sofie Ragnhild; Leboyer, Marion; Aas, Monica; Henry, Chantal; Bjella, Thomas; Andreassen, Ole A.; Bellivier, Frank; Lagerberg, Trine Vik

doi:10.1016/j.jad.2019.05.075

Cited by 22 publications

(13 citation statements)

References 78 publications

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“…In the same cohort, increased frequency of tobacco product use and contemporaneous use of multiple tobacco products were associated with higher depressive symptoms 62 . Current cigarette smoking also predicted current and 9‐month suicidal ideation and behavior and was a leading predictor of repeated suicide attempts in bipolar disorder 63,64 …”

Section: Results: Epidemiology and Pharmacologymentioning

confidence: 99%

Nicotine Inhalation and Suicide: Clinical Correlates and Behavioral Mechanisms

et al. 2021

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Background and Objectives Extensive evidence links smoking and suicide independently of psychiatric diagnoses, but there are questions about the pathophysiology and specificity of this relationship. We examined characteristics of this linkage to identify potential transdiagnostic mechanisms in suicide and its prevention. Methods We reviewed literature that associated suicide with smoking and e‐cigarettes, including the temporal sequence of smoking and suicide risk and their shared behavioral risk factors of sensitization and impulsivity. Results Smoking is associated with increased suicide across psychiatric diagnoses and in the general population, proportionately to the number of cigarettes smoked per day. Rapid nicotine uptake into the brain through inhalation of conventional cigarettes, electronic cigarettes (e‐cigarette), or even second‐hand smoke can facilitate long‐term sensitization and short‐term impulsivity. Both impair action regulation and predispose to negative affect, continued smoking, and suicidal behavior. Intermittent hypoxia, induced by cigarettes or e‐cigarettes, synergistically promotes impulsivity and sensitization, exacerbating suicidality. Two other shared behavioral risks also develop negative urgency (combined impulsivity and negative affect) and cross‐sensitization to stressors or to other addictive stimuli. Finally, early smoking onset, promoted by e‐cigarettes in never‐smokers, increases subsequent suicide risk. Conclusion and Scientific Significance Prevention or cessation of nicotine inhalation can strategically prevent suicidality and other potentially lethal behavior regardless of psychiatric diagnoses. Medications for reducing smoking and suicidality, especially in younger smokers, should consider the neurobehavioral mechanisms for acute impulsivity and longer‐term sensitization, potentially modulated more effectively through glutamate antagonism rather than nicotine substitution. (Am J Addict 2021;30:316–329)

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Section: Results: Epidemiology and Pharmacologymentioning

confidence: 99%

Nicotine Inhalation and Suicide: Clinical Correlates and Behavioral Mechanisms

et al. 2021

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“…AUDIT scores were missing for 18 participants at baseline and 22 at follow-up, and these were coded as misuse if their average number of alcohol units consumed per week the previous 6 months exceeded 7 for females and 14 for males ( n = 2 at both baseline and follow-up), in line with recommendations for maximum alcohol consumption in the Nordic countries ( 18 ). Finally, current daily use of nicotine was recorded both at baseline and follow-up since nicotine use is strongly related to all other forms of substance use or misuse ( 19 ), and has also been found to be associated with psychiatric outcomes such as suicidal risk in BD ( 20 ).…”

Section: Methodsmentioning

confidence: 99%

Substance Misuse Trajectories and Risk of Relapse in the Early Course of Bipolar Disorder

et al. 2021

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Substance misuse is highly prevalent in bipolar disorder even in the early illness phases. However, the trajectories of misuse of different substances after treatment initiation is not well-studied. Also, knowledge on how substance misuse trajectories influence the early course of bipolar disorder is limited. We recruited 220 individuals in first treatment of bipolar disorder of which 112 participated in a 1-year follow-up study at the NORMENT center in Oslo, Norway. Misuse was defined as having scores above cut-off for harmful use on the Alcohol or Drug Use Disorders Identification Tests (AUDIT or DUDIT). We investigated rates of stopping and continuing misuse of alcohol, cannabis and other illicit substances and daily nicotine use over the follow-up period, and whether such misuse trajectories predicted the risk for affective relapse. The prevalence of cannabis misuse was reduced from 29 to 15% and alcohol misuse was reduced from 39 to 21% during follow-up. Continuing alcohol misuse significantly and independently predicted affective relapse, whereas there was no difference in relapse risk between individuals stopping alcohol misuse and never misusing alcohol. Cannabis misuse trajectories did not significantly predict relapse risk although we cannot exclude interactions with alcohol misuse. In conclusion, substance misuse decreased in the early phase of bipolar disorder treatment but should be further reduced with interventions specifically addressing substance misuse. Stopping alcohol misuse is likely to yield substantial benefit on the clinical course of bipolar disorder.

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“…Genetic mechanisms related to suicide might differ depending upon specific phenotypes such as suicidal ideation (SI) or SA (Brent and Mann 2005 ; Mann et al 2005 ; Mullins et al 2014 ), and on underlying mental disorders. Also, multiple attempters showed demographic and clinical characteristics different from those of single attempters (Jeon et al 2010 ; Fedyszyn et al 2016 ; Arici et al 2018 ; Icick et al 2019 ; Papadopoulou et al 2020 ). In BD, previous studies reported multiple psychiatric comorbidities and substance abuse as clinical factors associated with repeated attempts (Arici et al 2018 ; Icick et al 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…Also, multiple attempters showed demographic and clinical characteristics different from those of single attempters (Jeon et al 2010 ; Fedyszyn et al 2016 ; Arici et al 2018 ; Icick et al 2019 ; Papadopoulou et al 2020 ). In BD, previous studies reported multiple psychiatric comorbidities and substance abuse as clinical factors associated with repeated attempts (Arici et al 2018 ; Icick et al 2019 ). However, most genetic studies on SA have used a single phenotype defined as “at least one SA in a lifetime” (Mullins et al 2014 ; Mullins et al 2019 ; Erlangsen et al 2020 ; Ruderfer et al 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Dissecting the genetic architecture of suicide attempt and repeated attempts in Korean patients with bipolar disorder using polygenic risk scores

Lee

Baek

et al. 2022

Int J Bipolar Disord

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Background Bipolar disorder (BD) has the greatest suicide risk among mental and physical disorders. A recent genome-wide association study (GWAS) of European ancestry (EUR) samples revealed that the genetic etiology of suicide attempt (SA) was not only polygenic but also, in part, diagnosis-specific. The authors aimed to examine whether the polygenic risk score (PRS) for SA derived from that study is associated with SA or repeated attempts in Korean patients with BD. This study also investigated the shared heritability of SA and mental disorders which showed an increased risk of SA and a high genetic correlation with BD. Methods The study participants were 383 patients with BD. The history of SA was assessed on a lifetime basis. PRSs for reference disorders were calculated using the aforementioned GWAS data for SA and the Psychiatric Genomics Consortium data of BD, schizophrenia, major depressive disorder (MDD), and obsessive–compulsive disorder (OCD). Results The PRS for SA was significantly associated with lifetime SA in the current subjects (Nagelkerke’s R2 = 2.73%, odds ratio [OR] = 1.36, p = 0.007). Among other PRSs, only the PRS for OCD was significantly associated with lifetime SA (Nagelkerke’s R2 = 2.72%, OR = 1.36, p = 0.007). The PRS for OCD was higher in multiple attempters than in single attempters (Nagelkerke’s R2 = 4.91%, OR = 1.53, p = 0.043). Conclusion The PRS for SA derived from EUR data was generalized to SA in Korean patients with BD. The PRS for OCD seemed to affect repeated attempts. Genetic studies on suicide could benefit from focusing on specific psychiatric diagnoses and refined sub-phenotypes, as well as from utilizing multiple PRSs for related disorders.

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Tobacco smoking and other substance use disorders associated with recurrent suicide attempts in bipolar disorder

Cited by 22 publications

References 78 publications

Nicotine Inhalation and Suicide: Clinical Correlates and Behavioral Mechanisms

Nicotine Inhalation and Suicide: Clinical Correlates and Behavioral Mechanisms

Substance Misuse Trajectories and Risk of Relapse in the Early Course of Bipolar Disorder

Dissecting the genetic architecture of suicide attempt and repeated attempts in Korean patients with bipolar disorder using polygenic risk scores

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