ArticleEuropean psychiatry : the journal of the Association of European Psychiatrists2025
Staging of suicidality in bipolar disorder: Findings from the FACE-BD cohort (FondaMental Advanced Centers of Expertise for Bipolar Disorders).
Article in European psychiatry : the journal of the Association of European Psychiatrists, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionSuicidal behaviors (SB) in bipolar disorder (BD) are major adverse outcomes that may influence disease progression. While staging models exist for psychiatric disorders, none include suicide. This study aims to stratify suicidal risk in BD, propose a staging model for SB, and assess its clinical utility.
methodsParticipants from the FondaMental Advanced Centers of Expertise for Bipolar Disorder (FACE-BD) cohort were categorized into five stages (St) based on SB: St0 (no suicidal ideation [SI]), St1 (SI but no suicide attempt [SA]), St2a (non-severe/violent SA), St2b (severe /violent SA), and St3 (multiple SAs). Stages were analyzed based on demographic, clinical, cognitive, and biological characteristics using logistic regression.
resultsKey differences emerged between stages. St1 showed longer untreated illness and higher lability and lower functioning than St0. St2a was linked to anxiety, substance use disorders, and longer disorder duration, while male gender and lithium bitherapy were protective. St2b exhibited shorter untreated illness and higher childhood trauma (CTQ) scores, with male gender and alcohol use as risk factors. St3 was associated with BD-II, alcohol use, longer disorder duration, and more depressive episodes, but less anxiety. No biochemical or cognitive differences were found across stages. The model was significantly associated with SA occurrence (LRT = 28.74,
conclusionsThis staging model for suicidality in BD provides a multifaceted approach to risk stratification and predictive insights, although further refinement is needed.
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