Cognition in Recent Suicide Attempts: Altered Executive Function

Abstract

Background: Neuropsychological alterations can lead to inaccurate perception, interpretation, and response to environmental information, which could be a risk factor for suicide.Methods: Ninety-six subjects were recruited from the Psychiatry Department of the Araba University Hospital—Santiago, including 20 patients with a recent attempt and diagnosis of major depressive disorder (MDD) according to DSM-V, 33 MDD patients with history of attempted suicide, 23 non-attempter MDD patients, and 20 healthy controls. All participants underwent a clinical interview and neuropsychological assessment on the following cognitive domains: working memory, processing speed, decision-making, executive function, and attention. Backward multiple regressions were performed adjusting for significant confounding variables. For group comparisons, ANOVA and Bonferroni post-hoc tests were performed with a p < 0.05 significance level.Results: The patient groups did not differ regarding severity of depression and stressful events in the last 6 months. In comparison to healthy controls, depressed patients with lifetime suicide attempts had more general trauma (p = 0.003), emotional abuse (p = 0.003), emotional negligence (p = 0.006), and physical negligence (p = 0.009), and depressed patients with recent suicide attempts had experienced more child sexual abuse (p = 0.038). Regarding neuropsychological assessment, all patient groups performed significantly worse than did healthy controls in processing speed, decision-making, and attention. Comparisons between patient groups indicated that recent suicide attempters had poorer performance on executive function in comparison to both depressed lifetime attempters and depressed non-attempters (B = 0.296, p = 0.019, and B = 0.301, p = 0.028, respectively). Besides, women with recent attempts had slightly better scores on executive function than males. Regarding the rest of the cognitive domains, there were no significant differences between groups.Conclusion: Executive function performance is altered in recent suicide attempts. As impaired executive function can be risk factor for suicide, preventive interventions on suicide should focus on its assessment and rehabilitation.

The mediating role of executive function in the relationship between self-stigma and self-injury or suicidal ideation among men who have sex with men living with HIV

“…Deficits in executive function can result in misunderstandings and inaccurate responses to internal and external environmental challenges; consequently, individuals may be easily overwhelmed and may engage in self-injury or suicidal ideation ( 26 ). Previous studies found executive function impairments among the HIV-negative population with suicidal ideation or suicidal behavior ( 27 – 29 ). Although limited evidence is available for HIV-positive individuals, one previous study suggested that suicidal ideation in this population might be a reflection of executive function deficits ( 30 ).…”

Neuropsychological functioning and suicidal behaviours in patients with first‐episode psychosis: A systematic review

“…51,52 One possible explanation for this finding could be that, even though executive functioning was not related to SB in this study, the previous literature did find that poorer executive functioning (defined as the neurocognitive function that organizes and directs behaviour and enables the perception, interpretation, and retrieval of, as well as response to environmental information) was associated with a pessimistic way of thinking about one's personal life. 25,53 Decision-making was one of the sub-domains of executive functioning that was consistently reported to be impaired in psychiatric populations with SB. [54][55][56] This might be associated with processing speed, visual memory, and psychomotor skills.…”

Cognitive Processes and Legal Capacity in Patients With Bipolar Disorder: A Brief Research Report

“…Thus, considering the BD patients in episodic and euthymic groups, the study results suggest that while BD patients are slower in terms of analysis, they may also be more impulsive than the general population, their mood state being a determinant for impulsiveness. Regarding to suicide attempts and neurocognitive functioning, Fernández-Sevillano et al (2021) studied cognition in patients that attempts to suicide and concluded that there were changes in the executive function performance when the episode was recent. However, in our sample, although 62% of patients in episode had been already suicide attempted, it was not recent.…”

“…We also emphasize that in our sample, in relation to the clinical group, we observed the occurrence of suicide. The literature shows that this is a variable that corresponds to cognitive impairment, according to the severity of the attempt and the time elapsed ( Fernández-Sevillano et al, 2021 ). As we did not control the type and possible sequelae, we emphasize that this is a feature limited to the present work, although in the Brazilian reality the legislation has a greater focus on considering the functional impact regardless of specificities such as, for example, a suicide attempt.…”