Peripheral immune–vascular correlates of suicidal thoughts and behaviors in bipolar disorder and schizophrenia: cross-sectional and prospective analyses from the FACE-BD and FACE-SZ cohorts

BACKGROUND: Bipolar disorder (BD) and schizophrenia-spectrum disorders (SZ) are associated with high rates of suicidal ideation (SI) and suicide attempts (SA). Peripheral immune-vascular abnormalities may contribute to suicidal vulnerability in these disorders, but their specificity, temporal meaning, and diagnostic patterning remain unclear. METHODS: We quantified 28 peripheral immune-vascular variables (cytokines/chemokines, vascular-injury markers, blood counts, lipids) in 980 French FACE (FondaMental Advanced Centres of Expertise) outpatients with BD (n = 529) or SZ (n = 451). Elastic-net logistic regression and partial least-squares regression for binary outcomes examined associations with SA, baseline SI, and SI over 12 months in pooled and diagnosis-stratified samples. Models adjusted for age, sex, and body mass index, with sensitivity analyses for depression severity, medication classes, smoking, phenotype overlap, attrition, and missing data. RESULTS: In pooled analyses, SA was associated with higher vascular endothelial growth factor; stratified analyses suggested this signal was mainly driven by BD (OR = 1.33, 95% CI 1.08-1.64). In SZ, SA showed weaker platelet/SAA-related associations. Baseline SI showed more consistent multivariate signals than individual analytes; in BD, higher IL-7 and SAA remained associated with SI after adjustment, whereas SZ findings were more medication-sensitive. SI over 12 months showed the least stable associations; in BD, lower IL-7 was associated with follow-up SI (OR = 0.72, 95% CI 0.54-0.96). Internal validation indicated stronger performance for baseline SI than for SA or follow-up SI. CONCLUSIONS: We found modest, phenotype-dependent and partly diagnosis-specific peripheral immune-vascular correlates of SI and SA in BD and SZ. Replication and direct biological validation are needed.

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Journal
Brain Behavior and Immunity
Published
2026-04-27
DOI
https://doi.org/10.1016/j.bbi.2026.106783
Primary Topic
Tryptophan and brain disorders
Type
article
Field-Weighted Citation Impact
0.00

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article

Peripheral immune–vascular correlates of suicidal thoughts and behaviors in bipolar disorder and schizophrenia: cross-sectional and prospective analyses from the FACE-BD and FACE-SZ cohorts

Émmanuel Haffen, Wahid Boukouaci, Caroline Barau, Fabrice Berna et al.
Brain Behavior and Immunity
Tryptophan and brain disorders
article

Peripheral immune–vascular correlates of suicidal thoughts and behaviors in bipolar disorder and schizophrenia: cross-sectional and prospective analyses from the FACE-BD and FACE-SZ cohorts

Émmanuel Haffen, Wahid Boukouaci, Caroline Barau, Fabrice Berna, Aistė Lengvenytė, Mircea Polosan, Ching‐Lien Wu, Antoine Lefrere A, Etienne Véry, Clément Dondé, Delphine Capdevielle, Théo Korchia, Antoine Yrondi, David Szekely, Dominique Januel, Caroline Dubertet, Marion Leboyer, Pierre-Michel Llorca, Romain Rey, Paul Roux, Bruno Aouizerate, David Misdrahi, Eric Fakra, Emilie Olié, Michel Walter, Philippe Courtet, Ludovic Samalin, Bruno Etain, Raymund Schwan, Frank Bellivier, Isabelle Chereau, Franck Schürhoff
article en

Abstract

BACKGROUND: Bipolar disorder (BD) and schizophrenia-spectrum disorders (SZ) are associated with high rates of suicidal ideation (SI) and suicide attempts (SA). Peripheral immune-vascular abnormalities may contribute to suicidal vulnerability in these disorders, but their specificity, temporal meaning, and diagnostic patterning remain unclear. METHODS: We quantified 28 peripheral immune-vascular variables (cytokines/chemokines, vascular-injury markers, blood counts, lipids) in 980 French FACE (FondaMental Advanced Centres of Expertise) outpatients with BD (n = 529) or SZ (n = 451). Elastic-net logistic regression and partial least-squares regression for binary outcomes examined associations with SA, baseline SI, and SI over 12 months in pooled and diagnosis-stratified samples. Models adjusted for age, sex, and body mass index, with sensitivity analyses for depression severity, medication classes, smoking, phenotype overlap, attrition, and missing data. RESULTS: In pooled analyses, SA was associated with higher vascular endothelial growth factor; stratified analyses suggested this signal was mainly driven by BD (OR = 1.33, 95% CI 1.08-1.64). In SZ, SA showed weaker platelet/SAA-related associations. Baseline SI showed more consistent multivariate signals than individual analytes; in BD, higher IL-7 and SAA remained associated with SI after adjustment, whereas SZ findings were more medication-sensitive. SI over 12 months showed the least stable associations; in BD, lower IL-7 was associated with follow-up SI (OR = 0.72, 95% CI 0.54-0.96). Internal validation indicated stronger performance for baseline SI than for SA or follow-up SI. CONCLUSIONS: We found modest, phenotype-dependent and partly diagnosis-specific peripheral immune-vascular correlates of SI and SA in BD and SZ. Replication and direct biological validation are needed.

Brain Behavior and ImmunityVol. 136
Université Claude Bernard Lyon 1 (FR), Centre National de la Recherche Scientifique (FR), Université Toulouse III - Paul Sabatier (FR), Université de Bordeaux (FR), Inserm (FR), Université de Versailles Saint-Quentin-en-Yvelines (FR), Université Paris-Est Créteil (FR), Université de Montpellier (FR), Université Paris Cité (FR), Université Paris-Saclay (FR), Centre Hospitalier Universitaire de Grenoble (FR), Sorbonne Université (FR), Université Sorbonne Paris Nord (FR), Centre Hospitalier Universitaire de Montpellier (FR), Centre de Recherche en Neurosciences de Lyon (FR), Fondation FondaMental (FR), Assistance Publique – Hôpitaux de Paris (FR), Institut de Neurosciences Cognitives et Intégratives d’Aquitaine (FR), Centre de recherche en Epidémiologie et Santé des Populations (FR), Imagerie Adaptative Diagnostique et Interventionnelle (FR), Hôpitaux Universitaires Henri-Mondor (FR), Centre Hospitalier Régional Universitaire de Brest (FR), Centre Hospitalier Le Vinatier (FR), NutriNeuro (FR), Hôpitaux Universitaires de Strasbourg (FR), Grenoble Institute of Neurosciences (FR), Centre Hospitalier Charles Perrens (FR), Université de Strasbourg (FR), Université Grenoble Alpes (FR)
Brain and Behavior Research Foundation, Agence Nationale de la Recherche
Gender equality
Openalex Percentile: Top 13%
Tryptophan and brain disorders
DOIOpen Access PDFOpenAlex
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