scholarly journals Neuropsychological function and suicidal behavior: attention control, memory and executive dysfunction in suicide attempt

2012 ◽  
Vol 43 (3) ◽  
pp. 539-551 ◽  
Author(s):  
J. G. Keilp ◽  
M. Gorlyn ◽  
M. Russell ◽  
M. A. Oquendo ◽  
A. K. Burke ◽  
...  
Keyword(s):  
Working Memory ◽  
Healthy Volunteers ◽  
Suicidal Behavior ◽  
Executive Dysfunction ◽  
Attention Control ◽  
Type I ◽  
Language Fluency ◽  
Major Depressive ◽  
Suicide Attempters ◽  
History Of

BackgroundExecutive dysfunction, distinct from other cognitive deficits in depression, has been associated with suicidal behavior. However, this dysfunction is not found consistently across samples.MethodMedication-free subjects with DSM-IV major depressive episode (major depressive disorder and bipolar type I disorder) and a past history of suicidal behavior (n = 72) were compared to medication-free depressed subjects with no history of suicidal behavior (n = 80) and healthy volunteers (n = 56) on a battery of tests assessing neuropsychological functions typically affected by depression (motor and psychomotor speed, attention, memory) and executive functions reportedly impaired in suicide attempters (abstract/contingent learning, working memory, language fluency, impulse control).ResultsAll of the depressed subjects performed worse than healthy volunteers on motor, psychomotor and language fluency tasks. Past suicide attempters, in turn, performed worse than depressed non-attempters on attention and memory/working memory tasks [a computerized Stroop task, the Buschke Selective Reminding Task (SRT), the Benton Visual Retention Test (VRT) and an N-back task] but not on other executive function measures, including a task associated with ventral prefrontal function (Object Alternation). Deficits were not accounted for by current suicidal ideation or the lethality of past attempts. A small subsample of those using a violent method in their most lethal attempt showed a pattern of poor executive performance.ConclusionsDeficits in specific components of attention control, memory and working memory were associated with suicidal behavior in a sample where non-violent attempt predominated. Broader executive dysfunction in depression may be associated with specific forms of suicidal behavior, rather than suicidal behavior per se.

Aggressiveness, not impulsiveness or hostility, distinguishes suicide attempters with major depression

2006 ◽  
Vol 36 (12) ◽  
pp. 1779-1788 ◽  
Author(s):  
JOHN G. KEILP ◽  
MARIANNE GORLYN ◽  
MARIA A. OQUENDO ◽  
BETH BRODSKY ◽  
STEVEN P. ELLIS ◽  
...  
Keyword(s):  
Major Depression ◽  
Suicidal Behavior ◽  
Borderline Personality ◽  
Biological Research ◽  
Major Depressive ◽  
Suicide Attempters ◽  
Large Numbers ◽  
History Of ◽  
Patient Subgroups ◽  
The Ideal

Background. Impulsiveness, hostility and aggressiveness are traits associated with suicidal behavior, but also with borderline personality disorder (BPD). The presence of large numbers of BPD subjects in past attempter samples may distort the relative importance of each of these traits to predicting suicidal behavior, and lead to prospective, biological and genetic models that systematically misclassify certain subpopulations of suicidal individuals.Method. Two hundred and seventy-five subjects with major depressive disorder (MDD), including 87 with co-morbid BPD (69 past suicide attempters, 18 non-attempters) and 188 without BPD (76 attempters, 112 non-attempters) completed standard impulsiveness, hostility and aggressiveness ratings. Differences between past suicide attempters and non-attempters were examined with the sample stratified by BPD status.Results. As expected, BPD subjects scored significantly higher than non-BPD subjects on all three trait measures. Stratifying by BPD status, however, eliminated attempter/non-attempter differences in impulsiveness and hostility in both patient subgroups. Past suicide attempters in each of the two subgroups of patients were only distinguished by higher levels of aggressiveness.Conclusions. Once BPD is accounted for, a history of aggressive behavior appears to be the distinguishing trait characteristic of suicide attempters with major depression, rather than global personality dimensions such as impulsiveness or hostility. Aggressiveness, and not these related traits, may be the ideal target for behavioral, genetic and biological research on suicidal behavior, as well as for the clinical assessment of suicide risk.

scholarly journals Neuropsychological deficits in past suicide attempters with varying levels of depression severity

2014 ◽  
Vol 44 (14) ◽  
pp. 2965-2974 ◽  
Author(s):  
J. G. Keilp ◽  
S. R. Beers ◽  
A. K. Burke ◽  
N. M. Melhem ◽  
M. A. Oquendo ◽  
...  
Keyword(s):  
Working Memory ◽  
Major Depression ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Past History ◽  
Clinical State ◽  
Suicide Attempters ◽  
History Of ◽  
Attention Memory ◽  
Interference Processing

BackgroundOur previous work identified deficits in interference processing and learning/memory in past suicide attempters who were currently depressed and medication-free. In this study, we extend this work to an independent sample studied at various stages of illness and treatment (mild symptoms, on average) to determine if these deficits in past suicide attempters are evident during a less severe clinical state.MethodA total of 80 individuals with a past history of major depression and suicide attempt were compared with 81 individuals with a history of major depression and no lifetime suicide attempts on a battery of neurocognitive measures assessing attention, memory, abstract/contingent learning, working memory, language fluency and impulse control.ResultsPast attempters performed more poorly in attention, memory and working memory domains, but also in an estimate of pre-morbid intelligence. After correction for this estimate, tests that had previously distinguished past attempters – a computerized Stroop task and the Buschke Selective Reminding Test – remained significantly worse in attempters. In a secondary analysis, similar differences were found among those with the lowest levels of depression (Hamilton Depression Rating Scale score <10), suggesting that these deficits may be trait markers independent of current symptomatology.ConclusionsDeficits in interference processing and learning/memory constitute an enduring defect in information processing that may contribute to poor adaptation, other higher-order cognitive impairments and risk for suicidal behavior.

A History of Major Depressive Disorder Influences Intent to Die in Violent Suicide Attempters

2004 ◽  
Vol 65 (5) ◽  
pp. 690-695 ◽  
Author(s):  
Bernard Astruc ◽  
Stephane Torres ◽  
Fabrice Jollant ◽  
Sophie Jean-Baptiste ◽  
Didier Castelnau ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Major Depressive ◽  
Suicide Attempters ◽  
History Of

scholarly journals Bipolar disorder first episode and suicidal behavior: are there differences according to type of suicide attempt?

2009 ◽  
Vol 31 (2) ◽  
pp. 114-118 ◽  
Author(s):  
Fernando Silva Neves ◽  
Leandro Fernandes Malloy-Diniz ◽  
Izabela Guimarães Barbosa ◽  
Paulo Marcos Brasil ◽  
Humberto Corrêa
Keyword(s):  
Bipolar Disorder ◽  
Logistic Regression ◽  
Suicidal Behavior ◽  
Suicide Attempts ◽  
First Episode ◽  
Mean Square ◽  
Suicide Attempters ◽  
Lifetime History ◽  
Bipolar Ii ◽  
History Of

OBJECTIVE: The objective of this study was to test the hypothesis that the polarity of the first mood episode may be a marker for suicidal behavior, particularly the violent subtype. METHOD: One hundred and sixty-eight patients diagnosed with bipolar disorder (DSM-IV) were grouped according to type of first episode: depression or manic/hypomanic. Groups were compared for demographic and clinical variables. We performed logistic regression in order to test the association between first episode polarity and suicidal behavior. RESULTS: We found that depressed patients have a lifetime history of more suicide attempts. However, univariate analysis of number of suicide attempts showed that the best model fits the bipolar II subtype (mean square = 15.022; p = 0.010) and lifetime history of psychotic episodes (mean square = 17.359; p = 0.021). Subgrouping the suicide attempts by subtype (violent or non-violent) revealed that manic/hypomanic patients had a greater tendency toward attempting violent suicide (21.2 vs. 14.7%, X² = 7.028, p = 0.03). Multiple logistic regression analysis confirmed this result. CONCLUSION: Depressed patients had more suicide attempts over time, which could be explained by the higher prevalence of bipolar II subtype in this group, whereas manic/hypomanic patients had a lifelong history of more frequent violent suicide attempts, not explained by any of the variables studied. Our results support the evidence that non-violent suicide attempters and violent suicide attempters tend to belong to different phenotypic groups.

Prolactin Response to Fenfluramine and Suicide Attempt Lethality in Major Depression

1996 ◽  
Vol 168 (3) ◽  
pp. 324-329 ◽  
Author(s):  
Kevin M. Malone ◽  
Elizabeth M. Corbitt ◽  
Shuhua Li ◽  
J. John Mann
Keyword(s):  
Suicide Attempt ◽  
Suicide Attempts ◽  
Challenge Test ◽  
Major Depressive ◽  
Suicide Attempters ◽  
Lifetime History ◽  
Serotonin System ◽  
History Of ◽  
Serotonergic Function ◽  
Prolactin Response

BackgroundThis study employed an alternative method for assessing serotonergic function to further evaluate our finding that cerebrospinal fluid (CSF) 5-hydroxyindole acetic acid (5-HIAA) in depressed suicide attempters with a lifetime history of higher lethality suicide attempts is significantly lower compared to depressed patients who have a history of low lethality suicide attempts.MethodWe used dl-fenfluramine (60 mg) as a neuroendocrine probe to examine the serotonin system in 41 in-patients with a DSM–III–R major depressive episode, divided into two groups on the basis of a lifetime history of high or low lethality suicide attempts. Fenfluramine challenge test outcome was defined as the maximum prolactin response in the five hours following fenfluramine.ResultsPatients with a history of a higher lethality suicide attempt had a significantly lower prolactin response to fenfluramine, even when controlling for cortisol, age, sex, weight, comorbid cluster B personality disorder, pharmacokinetic and menstrual cycle effects.ConclusionsThe data provide further support for the hypothesis that serotonin dysfunction is associated with more lethal suicide attempts, and suggests that higher lethality suicide attempters or failed suicides resemble completed suicides both behaviourally and biochemically.

scholarly journals Paralimbic and lateral prefrontal encoding of reward value during intertemporal choice in attempted suicide

2015 ◽  
Vol 46 (2) ◽  
pp. 381-391 ◽  
Author(s):  
P. M. Vanyukov ◽  
K. Szanto ◽  
M. N. Hallquist ◽  
G. J. Siegle ◽  
C. F. Reynolds ◽  
...  
Keyword(s):  
Suicidal Behavior ◽  
Intertemporal Choice ◽  
Suicide Attempts ◽  
Preliminary Evidence ◽  
Posterior Cingulate Cortex ◽  
Suicide Attempters ◽  
Subjective Value ◽  
History Of ◽  
Medication Exposure ◽  
Neural Underpinnings

BackgroundAlongside impulsive suicide attempts, clinicians encounter highly premeditated suicidal acts, particularly in older adults. We have previously found that in contrast to the more impulsive suicide attempters’ inability to delay gratification, serious and highly planned suicide attempts were associated with greater willingness to wait for larger rewards. This study examined neural underpinnings of intertemporal preference in suicide attempters. We expected that impulsivity and suicide attempts, particularly poorly planned ones, would predict altered paralimbic subjective value representations. We also examined lateral prefrontal and paralimbic correlates of premeditation in suicidal behavior.MethodA total of 48 participants aged 46–90 years underwent extensive clinical and cognitive characterization and completed the delay discounting task in the scanner: 26 individuals with major depression (13 with and 13 without history of suicide attempts) and 22 healthy controls.ResultsMore impulsive individuals displayed greater activation in the precuneus/posterior cingulate cortex (PCC) to value difference favoring the delayed option. Suicide attempts, particularly better-planned ones, were associated with deactivation of the lateral prefrontal cortex (lPFC) in response to value difference favoring the immediate option. Findings were robust to medication exposure, depression severity and possible brain damage from suicide attempts, among other confounders. Finally, in suicide attempters longer reward delays were associated with diminished parahippocampal responses.ConclusionsImpulsivity was associated with an altered paralimbic (precuneus/PCC) encoding of value difference during intertemporal choice. By contrast, better-planned suicidal acts were associated with altered lPFC representations of value difference. The study provides preliminary evidence of impaired decision processes in both impulsive and premeditated suicidal behavior.

scholarly journals White matter correlates of impaired attention control in major depressive disorder and healthy volunteers

2017 ◽  
Vol 222 ◽  
pp. 103-111 ◽  
Author(s):  
Mina M. Rizk ◽  
Harry Rubin-Falcone ◽  
John Keilp ◽  
Jeffrey M. Miller ◽  
M. Elizabeth Sublette ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
White Matter ◽  
Depressive Disorder ◽  
Healthy Volunteers ◽  
Attention Control ◽  
Major Depressive ◽  
Impaired Attention

Cognitive inhibition in depression and suicidal behavior: a neuroimaging study

2015 ◽  
Vol 46 (5) ◽  
pp. 933-944 ◽  
Author(s):  
S. Richard-Devantoy ◽  
Y. Ding ◽  
M. Lepage ◽  
G. Turecki ◽  
F. Jollant
Keyword(s):  
Parietal Cortex ◽  
Suicidal Behavior ◽  
Orbitofrontal Cortex ◽  
Cognitive Impairments ◽  
Inferior Frontal Gyrus ◽  
Brain Activation ◽  
Cognitive Inhibition ◽  
Global Functioning ◽  
Suicide Attempters ◽  
History Of

BackgroundCognitive inhibition deficits have previously been found in suicide attempters. This study examined the neural basis for these deficits in depressed patients with and without a history of suicidal behavior.MethodFunctional magnetic resonance imaging was used to measure brain activation during the Go/No-Go response inhibition task in 25 unmedicated and depressed middle-aged suicide attempters, 22 unmedicated depressed patient controls with no personal or family history of suicidal behavior, and 27 healthy controls. Whole-brain analyses were conducted with SPM12.ResultsSuicide attempters exhibited an elevated number of commission errors relative to both control groups. However, suicide attempters did not differ from patient controls in terms of brain activation for any contrast. Analyses showed a significant association between depression and brain activation in the left inferior frontal gyrus and medial thalamus during Go v. No-Go, and in the bilateral parietal cortex and left orbitofrontal cortex during No-Go v. baseline. These regions were correlated with psychological pain, suicidal ideation and global functioning. There was no association between brain activation and personal histories of suicidal act.ConclusionsOur study suggests that deficits in cognitive inhibition, in relation to the inferior frontal gyrus, thalamus, orbitofrontal cortex and parietal cortex, are related to the depressive state and not specifically to suicide vulnerability. We hypothesize that state-related deficits may add to trait-like cognitive impairments to facilitate suicidal acts. These different types of cognitive impairments may necessitate different therapeutic strategies for the prevention of suicide.

scholarly journals Hippocampal Subfield Volumes in Major Depressive Disorder Adolescents with a History of Suicide Attempt

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Qi Zhang ◽  
Su Hong ◽  
Jun Cao ◽  
Yi Zhou ◽  
Xiaoming Xu ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Suicide Attempt ◽  
Depressive Disorder ◽  
Suicidal Behavior ◽  
Clinical Characteristics ◽  
Suicide Attempts ◽  
Healthy Controls ◽  
Major Depressive ◽  
Suicide Attempters ◽  
Functional Studies

Suicidal behavior is a leading cause of death and often commences during adolescence/young adulthood (15~29 years old). The hippocampus, which consists of multiple functionally specialized subfields, may contribute to the pathophysiology of depression and suicidal behavior. We aimed to investigate the differences of hippocampal subfield volume between major depressive disorder (MDD) patients with and without suicide attempts and healthy controls in adolescents and young adults. A total of 40 MDD suicide attempters (MDD+SA), 27 MDD patients without suicide attempt (MDD-SA), and 37 healthy controls (HC) were recruited. High-resolution T1 MRI images were analyzed with the automated hippocampal substructure module in FreeSurfer 6.0. Volume differences among the groups were analyzed by a generalized linear model controlling for intracranial cavity volume (ICV). The relationship between hippocampal subfield volumes and clinical characteristics (HAM-D and SSI scores) was assessed using two-tailed partial correlation controlling for ICV in MDD+SA and MDD-SA. We found that MDD-SA had significantly smaller bilateral hippocampal fissure volume than HC and MDD+SA. No significant correlation was observed between hippocampal subfield volume and clinical characteristics (HAM-D and SSI scores) in MDD+SA and MDD-SA. Adolescent/young adult suicide attempters with MDD suicide attempters have larger bilateral hippocampal fissures than depressed patients without suicide attempts, independently from clinical characteristics. Within the heterogeneous syndrome of major depressive disorder that holds a risk for suicidality for subgroups, hippocampal morphology may help to explain or possibly predict such risk, yet longitudinal and functional studies are needed for understanding the biological mechanisms underlying.

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