Cognition in Recent Suicide Attempts: Altered Executive Function

Abstract

<b>Background:</b> Neuropsychological alterations can lead to inaccurate perception, interpretation, and response to environmental information, which could be a risk factor for suicide. <b>Methods:</b> 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 <i>post-hoc</i> tests were performed with a <i>p</i> < 0.05 significance level. <b>Results:</b> 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 (<i>p</i> = 0.003), emotional abuse (<i>p</i> = 0.003), emotional negligence (<i>p</i> = 0.006), and physical negligence (<i>p</i> = 0.009), and depressed patients with recent suicide attempts had experienced more child sexual abuse (<i>p</i> = 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 (<i>B</i> = 0.296, <i>p</i> = 0.019, and <i>B</i> = 0.301, <i>p</i> = 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. <b>Conclusion:</b> 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.