title: Affect lability predicts occurrence of suicidal ideation in bipolar patients: a two-year prospective study.
abstract: OBJECTIVE
  The aim of our study was to investigate, in bipolar patients, whether affect lability was associated with suicidal ideation incidence during 2-year follow-up, and which subtype of affect lability was associated with suicidal ideation.
  
  
  METHODS
  A total of 319 euthymic or mildly depressed bipolar outpatients recruited in the French FondaMental Advanced Centres of Expertise for Bipolar Disorder were divided into two subgroups according to the occurrence of suicidal ideation during a 2-year follow-up. Affect lability was assessed by the French version of the Affect Lability Scale.
  
  
  RESULTS
  Bipolar patients with high affect lability were more likely to report suicidal ideation during follow-up, even after adjustment for age, study level, rapid cycling, current depression level, anxiety disorder, and lifetime history SA (OR = 2.47; 95% CI [1.15-5.30], P = 0.01). The risk of suicidal ideation increased with the level of affect lability. More specifically, the propensity to switch from neutral to elation affect, from anxious to depressive affect (or inversely), and from neutral to anger affect predicted suicidal ideation.
  
  
  CONCLUSIONS
  Reducing affective lability could become a new therapeutic target of suicidal prevention in bipolar disorder.
authors.affiliation: CHU Montpellier, Hôpital Lapeyronie, Department of Emergency Psychiatry and Post Acute Care, CHRU Montpellier, Montpellier, France.|Inserm, U1061 Montpellier, University of Montpellier, Montpellier, France.|Fondation FondaMental, Créteil, France.
authors.forename: D
authors.identifier: http://orcid.org/0000-0003-3874-5748
authors.initials: D
authors.lastname: Ducasse
authors.affiliation: Inserm, U1061 Montpellier, University of Montpellier, Montpellier, France.
authors.forename: I
authors.initials: I
authors.lastname: Jaussent
authors.affiliation: CHU Montpellier, Hôpital Lapeyronie, Department of Emergency Psychiatry and Post Acute Care, CHRU Montpellier, Montpellier, France.|Inserm, U1061 Montpellier, University of Montpellier, Montpellier, France.|Fondation FondaMental, Créteil, France.
authors.forename: S
authors.initials: S
authors.lastname: Guillaume
authors.affiliation: Fondation FondaMental, Créteil, France.|AP HM, Psychiatric Pole, Sainte Marguerite, Marseille, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Azorin
authors.affiliation: Fondation FondaMental, Créteil, France.|Hospital Saint-Louis - Lariboisière - Fernand Widal, AP-HP, Paris, France.
authors.forename: F
authors.identifier: http://orcid.org/0000-0002-3660-6640
authors.initials: F
authors.lastname: Bellivier
authors.affiliation: Fondation FondaMental, Créteil, France.|AP HM, Psychiatric Pole, Sainte Marguerite, Marseille, France.
authors.forename: R
authors.initials: R
authors.lastname: Belzeaux
authors.affiliation: Fondation FondaMental, Créteil, France.|Academic Hospital of Grenoble, Grenoble, France.
authors.forename: T
authors.initials: T
authors.lastname: Bougerol
authors.affiliation: Fondation FondaMental, Créteil, France.|Université Paris-Est, Hopital Henri Mondor, DHU PePSY and AP-HP, Créteil, France.
authors.forename: B
authors.identifier: http://orcid.org/0000-0002-5377-1488
authors.initials: B
authors.lastname: Etain
authors.affiliation: Fondation FondaMental, Créteil, France.|Charles Perrens Hospital, Bordeaux, France.
authors.forename: S
authors.initials: S
authors.lastname: Gard
authors.affiliation: Fondation FondaMental, Créteil, France.|Université Paris-Est, Hopital Henri Mondor, DHU PePSY and AP-HP, Créteil, France.
authors.forename: C
authors.initials: C
authors.lastname: Henry
authors.affiliation: Fondation FondaMental, Créteil, France.|Brabois Hospital, Academic Hospital of Nancy, Vandoeuvre Les Nancy, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Kahn
authors.affiliation: Fondation FondaMental, Créteil, France.|Université Paris-Est, Hopital Henri Mondor, DHU PePSY and AP-HP, Créteil, France.
authors.forename: M
authors.initials: M
authors.lastname: Leboyer
authors.affiliation: Fondation FondaMental, Créteil, France.|Department of Psychiatry, Princesse-Grace Hospital, Monaco.
authors.forename: J
authors.initials: J
authors.lastname: Loftus
authors.affiliation: Fondation FondaMental, Créteil, France.|Academic Hospital of Versailles, Le Chesnay, France.
authors.forename: C
authors.initials: C
authors.lastname: Passerieux
authors.affiliation: CHU Montpellier, Hôpital Lapeyronie, Department of Emergency Psychiatry and Post Acute Care, CHRU Montpellier, Montpellier, France.|Inserm, U1061 Montpellier, University of Montpellier, Montpellier, France.|Fondation FondaMental, Créteil, France.
authors.forename: E
authors.initials: E
authors.lastname: Olié
authors.affiliation: CHU Montpellier, Hôpital Lapeyronie, Department of Emergency Psychiatry and Post Acute Care, CHRU Montpellier, Montpellier, France.|Inserm, U1061 Montpellier, University of Montpellier, Montpellier, France.|Fondation FondaMental, Créteil, France.
authors.forename: P
authors.initials: P
authors.lastname: Courtet
mesh_terms: D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*
keywords: affect lability; bipolar disorder; prospective follow-up study; suicidal ideation