الفهرس 
Nicotine Dependence: Cultural Issue or Clinical DilemmaOnly 14 pages are availabe for public view
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Abstract
Summary
Bipolar disorder is a severe, episodic, lifelong mood disorder. The traditional defining feature of bipolar disorder is the occurrence of episodes of mania or hypomania alternating, or occurring currently with, depressive episodes. Episodes in bipolar disorder are usually separated by periods of recovery, with return to normal function, but recurrence rates are high.
The estimated lifetime prevalence of bipolar disorder among adults worldwide is 1 to 3 percent. The World Health Organization estimated that bipolar disorder was the 46th greatest cause of disability and mortality in the world.
Community surveys in 14 countries found that the lifetime prevalence of bipolar I and bipolar II disorder was 2.8 percent10. Another set of community surveys in 11 countries found that the lifetime prevalence of bipolar I disorder was 0.6 percent and bipolar II disorder 0.4 percent with the mean age of onset for bipolar I disorder at 18 years and for bipolar II disorder at 20 years16.
According to DSM-5, bipolar disorders are classified to bipolar I disorder, bipolar II disorder, cyclothymic disorder, substance/medication induced bipolar disorder, bipolar disorder due to another medical condition, other specified bipolar disorder, unspecified bipolar disorder.
Cigarette smoking is the leading preventable cause of mortality, responsible for nearly six million deaths worldwide and 480,000 deaths in the United States (US) annually if present trends continue this toll is projected to rise to over eight million deaths per year by 2030, with 80 percent of those deaths occurring in the developing world where tobacco use is increasing. Up to one half of all tobacco users can be expected to die from a tobacco related disease. The economic burden of tobacco use in the United States is estimated to be $289 to 332.5 billion per year, which includes $132.5 to 175.9 billion in health care costs and an additional $151 billion in productivity losses.
The current study was conducted to assess the association of cigarette and waterpipe smoking with bipolar disorder. A number of 100 cases of bipolar disorder were recruited from both the inpatient department and the outpatient mood clinic of the psychiatric institute at Ain Shams University according to standard inclusion and exclusion criteria. Cases were compared to healthy 100 controls that were recruited from the caregivers and employees at the same hospital in the period between July 2014 and February 2015. Both cases and controls were assessed by the Ain shams clinical interview, the Mini International Neuropsychiatric Interview, The Fragerstrom test for nicotine dependence, the Young mania rating scale and the Lebanon Waterpipe Dependence Scale. Data were analyzed by SPSS 20 program. The results showed higher prevalence of cigarette smoking and waterpipe smoking among patients with bipolar disorder. Also, there was higher prevalence of anxiety disorders in patients with bipolar disorder when compared to healthy controls. Yet, no effect was found of comorbid anxiety on either cigarette or waterpipe smoking pattern.