Cigarette smoking differentially affects performance on both general and social cognition in patients with bipolar disorder (BD) as a function of psychosis history, a recent study found. These results suggest that there may be at least partially divergent underlying neurobiological causes for cognitive dysfunction in patients with BD with and without psychosis. Researchers assessed smoking status in 105 euthymic patients with BD, who completed a comprehensive battery that included social and general cognitive measures. They found:

• Within the nonpsychotic subgroup with BD (n=45), smokers generally outperformed nonsmokers; by contrast, for subjects with BD with a history of psychosis (n=41), nonsmokers outperformed smokers.
• This pattern was noted more globally using a general composite cognitive score and on social/affective measures assessing patients’ ability to identify emotions of facial stimuli and solve emotional problems.