Executive functioning in depressed patients with suicidal ideation

Marzuk, Peter M.; Hartwell, Nancy; Leon, Andrew C.; Portera, Laura

doi:10.1111/j.1600-0447.2005.00585.x

Cited by 217 publications

(164 citation statements)

References 43 publications

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“…The present study links executive dysfunction with the emergence of suicidal ideas rather than their implementation. Marzuk and colleagues (16) similarly found that current suicidal was related to executive deficits regardless of history of suicidal behavior. Later, Westheide et al (14) also found that only suicide attempters with current suicidal ideation, compared to attempters with no current suicidal ideation displayed cognitive impairments in decision-making and motor inhibition (31).…”

Section: Discussionmentioning

confidence: 99%

“…Marzuk et al (16) examined the association between current suicidal ideation and neuropsychological functioning by comparing a group of adults who were seriously contemplating suicide (60% with past suicide attempts) with a group of non-suicidal depressed participants (40% with past suicide attempts). The group with current suicidal ideation performed worse on several measures of executive function, specifically on tasks assessing set-shifting (e.g., the WCST, Trails Making Test Part B, and the Mazes subtest of the Wechsler Adult Intelligence Scale III), but showed no impairment on other cognitive measures.…”

Section: Introductionmentioning

confidence: 99%

“…The present case-control study aimed to examine whether executive function impairments are associated with contemplation of suicide (16), suicidal behavior (10, 11, 17), or both, in late life, above and beyond the effect of depression. Thus, we report performance on the EXIT in both suicide attempters and suicide ideators separately, compared with groups of non-suicidal depressed older adults, and older adults with no lifetime psychiatric history.…”

Section: Introductionmentioning

confidence: 99%

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Impaired Executive Function in Contemplated and Attempted Suicide in Late Life

Gujral

Dombrovski

Butters

et al. 2014

The American Journal of Geriatric Psychiatry

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Objective Executive deficits may play an important role in late-life suicide. Yet, current evidence in this area is inconclusive and does not indicate whether these deficits are broadly associated with suicidal ideation or specific to suicidal behavior. This study examined global cognition and specifically executive function impairments as correlates of suicidal ideation and suicidal behavior in depressed older adults, with the goal of extending an earlier preliminary study. Design Case-control study. Setting University-affiliated psychiatric hospital. Participants All were aged 60+: 83 depressed suicide attempters, 43 depressed individuals having suicidal ideation with a specific plan, 54 non-suicidal depressed participants, and 48 older adults with no history of psychiatric disorders. Measurements Global cognitive function - Dementia Rating Scale (DRS), Executive function - Executive Interview (EXIT). Results Both suicide attempters and suicide ideators performed worse than the two comparison groups on the EXIT, with no difference between suicide attempters and suicide ideators. On the DRS total score, as well as on Memory and Attention subscales, suicide attempters and ideators and non-suicidal depressed subjects performed similarly and were impaired relative to with non-psychiatric control subjects. Controlling for education, substance use disorders, and medication exposure did not affect group differences in performance on either the EXIT or DRS. Conclusions Executive deficits, captured with a brief instrument, are associated broadly with suicidal ideation in older depressed adults but do not appear to directly facilitate suicidal behavior. Our data are consistent with the idea that different vulnerabilities may operate at different stages in the suicidal process.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impaired Executive Function in Contemplated and Attempted Suicide in Late Life

Gujral

Dombrovski

Butters

et al. 2014

The American Journal of Geriatric Psychiatry

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“…Prefrontal areas of the brain, which are responsible for the evaluation of changing alternatives and the execution of plans, are often implicated in executive tasks. 14 Most executive functions are linked to the dorsolateral prefrontal cortex, whereas response inhibition is associated with the orbitofrontal region. 15 …”

mentioning

confidence: 99%

“…A study comparing depressed patients with and without suicidal ideation showed that those with ideation performed significantly worse on some measures of reasoning and flexibility, but not on a test of inhibition. 14 Other analyses have yielded no significant relationships between neuropsychological performance and measures of suicidality in patients with depression and psychotic disorders, leading some to hypothesize that suicidality is a separate domain that is distinct from psychiatric symptomatology and neurocognitive performance. 23,24 …”

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confidence: 99%

Differential Effects of Executive Functioning on Suicide Attempts

Burton¹,

Vella²,

Weller³

et al. 2011

Journal of Neuropsychiatry

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Suicide is common among individuals with psychiatric illness; executive functioning may be associated with suicide risk. The authors examined demographic, clinical, and executive-functioning variables in suicide ideators and suicide attempters, hypothesizing that attempters would demonstrate poorer executive-functioning skills. Seventy-seven participants with psychiatric illness completed a neuropsychological battery while hospitalized or residing in crisis-houses after expressing suicidal ideation (N=40) or making a suicide attempt (N=37). Logistic regression predicted suicide Ideator versus suicide Attempter status; suicide Attempters exhibited poorer inhibition but better problem-solving ability than suicide Ideators. Suicide attempt risk may be associated with better problem-solving skills, but worse inhibitory control.

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