The purpose of this study is to examine whether tobacco smoking is associated with bipolar affective disorder (severity of depressive and manic symptoms, presence of psychotic symptoms, history of a suicide attempts and other clinical features.)

An association exists between smoking and schizophrenia, independent of other factors and related to psychotic symptomatology. Only a few small descriptive studies have examined the prevalence and correlates of tobacco use among bipolar patients with conflicting results. Patients who smoke score higher on rating scales for psychotic symptoms than their non-smoking peers. While the association of smoking with psychotic symptomatology in schizophrenia is established, such association according to bipolar affective disorder has been reported in a few studies and remains unclear. Also a few studies reported about association of smoking with depressive and manic symptoms, and with suicidal behavior in bipolar patients. Thus further investigation of these issues is warranted.

Inclusion Criteria:

• Age 18-65 male or female
• DSM -IV criteria for bipolar I affective disorder
• Ability and willingness to sign informed consent for participation in the study

Exclusion Criteria:

• Unwillingness or inability to participate in the study

The sample will consist of all patients ascertained in database of Tirat Carmel Mental Health Center and Psychiatric Outpatients Clinic, Rambam Medical Center