‘Cool’ and ‘Hot’ executive functions in suicide attempters with major depressive disorder

Ho, Ming Chou; Hsu, Yi Chieh; Lu, Mong Liang; Gossop, Michael; Chen, Vincent Chin Hung

doi:10.1016/j.jad.2018.04.057

Cited by 40 publications

(16 citation statements)

References 48 publications

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“…Only the depressed patients with suicidal ideation showed executive dysfunctions, particularly in the decision-making tasks. In a more recent study by Ming-Chou Ho et al [37] where they evaluated the EF of 34 MDD attempters, 36 MDD non-attempters, and 55 healthy controls their findings were consistent with previous review and meta-analytic studies. To date there is no longitudinal study following first depressive episodes, which examine whether alterations in one or more EF, or other cognitive alterations, will predict suicidal ideation, attempts or subsequent consummate suicidal behavior.…”

Section: Introductionsupporting

confidence: 82%

Suicidal risk and executive functions in major depressive disorder: a study protocol

et al. 2019

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Background Suicide is a serious public health concern. Depression is the main gateway to suicidal behavior. The already established relationship between depression and suicidal risk should now focus on the investigation of more specific factors: recent studies have suggested an association between vulnerability to suicidal behavior and neurocognitive alterations, a nuclear symptom of depression. This project aims to identify alterations in the Executive Functions (EF) of patients suffering a first depressive episode that might constitute a risk factor for suicidal ideation, suicidal attempts and suicide, to allow for more adequate suicide prevention. Methods Prospective longitudinal design involving two groups (first depressive episodes with and without alterations in their EF) and four repeated measures (0, 6, 12 and 24 months). The estimated minimum sample size is 216 subjects. The variables and measurement instruments will include socio-demographic variables, clinical variables (age of illness onset, family and personal antecedents, psychopathological and medical comorbidity, suicidal ideation, suicide attempts and completed suicides, severity of depression, including melancholic or atypical, remission of the depressive episode), and neuropsychological variables (EF and decision-making processes evaluated through the Cambridge Neuropsychological Test Automated Battery (CANTAB)). Discussion First and foremost, the identification of clinical and neuropsychological risk factors associated with suicidal behavior will open the possibility to prevent such behavior in patients with a first depressive episode in the context of clinical practice. Secondly, interventions aimed at cognitive impairment (in particular: EF) derived from the study may be incorporated into strategies for the prevention of suicidal behavior. Finally, impaired neurocognitive function (even in early stages) could become an identifiable endophenotype or “marker” in clinical and neurobiological studies about suicidal behavior in depressive patients.

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Section: Introductionsupporting

confidence: 82%

Suicidal risk and executive functions in major depressive disorder: a study protocol

et al. 2019

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“…133,136 One of the neuropsychological domains strongly impaired in MDD regards the executive function, a set of self-regulatory cognitive processes essential for adaptive behaviour. [137][138][139][140][141][142][143]…”

Section: Neuropsychological and Neurocognitive Factorsmentioning

confidence: 99%

Understanding the Complex of Suicide in Depression: from Research to Clinics

Orsolini

Latini²,

Pompili³

et al. 2020

Psychiatry Investig

255

167

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Objective Amongst psychiatric disorders, major depressive disorder (MDD) is the most prevalent, by affecting approximately 15–17% of the population and showing a high suicide risk rate equivalent to around 15%. The present comprehensive overview aims at evaluating main research studies in the field of MDD at suicide risk, by proposing as well as a schematic suicide risk stratification and useful flow-chart for planning suicide preventive and therapeutic interventions for clinicians.Methods A broad and comprehensive overview has been here conducted by using PubMed/Medline, combining the search strategy of free text terms and exploded MESH headings for the topics of ‘Major Depressive Disorder’ and ‘Suicide’ as following: ((<i>suicide</i> [Title/Abstract]) AND (<i>major depressive disorder</i> [Title/Abstract])). All articles published in English through May 31, 2019 were summarized in a comprehensive way.Results Despite possible pathophysiological factors which may explain the complexity of suicide in MDD, scientific evidence supposed the synergic role of genetics, exogenous and endogenous stressors (i.e., interpersonal, professional, financial, as well as psychiatric disorders), epigenetic, the hypothalamic-pituitary-adrenal stress-response system, the involvement of the monoaminergic neurotransmitter systems, particularly the serotonergic ones, the lipid profile, neuro-immunological biomarkers, the Brain-derived neurotrophic factor and other neuromodulators.Conclusion The present overview reported that suicide is a highly complex and multifaceted phenomenon in which a large plethora of mechanisms could be variable implicated, particularly amongst MDD subjects. Beyond these consideration, modern psychiatry needs a better interpretation of suicide risk with a more careful assessment of suicide risk stratification and planning of clinical and treatment interventions.

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“…Some studies found that patients with MDD exhibited lower net scores on IGT compared with HCs (Cella et al, ; Moniz et al, ; Must et al, ), while Smoski et al () reported an opposite result with a better performance of IGT in the MDD group. There are also some researchers reporting no significant difference in net scores of IGT between patients with MDD and HCs (Deisenhammer, Schmid, Kemmler, Moser, & Delazer, ; Ho, Hsu, Lu, Gossop, & Chen, ; Saperia et al, ). In patients with BD, the results are also complicated.…”

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confidence: 99%

A transdiagnostic comparison of affective decision‐making in patients with schizophrenia, major depressive disorder, or bipolar disorder

Zhou

Ye³

et al. 2020

PsyCh Journal

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Deficit in decision-making has been found in patients with schizophrenia (SCZ), major depressive disorder (MDD), and bipolar disorder (BD), respectively, while the common and distinct characteristics of this deficit among these patients are still unclear. The present study aimed to make a transdiagnostic comparison of the affective decision-making ability in patients with SCZ, MDD, and BD. In this study, 33 patients with SCZ, 23 patients with MDD, 29 patients with BD, and 34 healthy controls (HCs) were recruited and the Iowa Gambling Task (IGT) was used to assess the affective decision-making ability. The results showed that all three diagnostic groups tended to select the disadvantageous decks but not advantageous decks compared to HCs. For patients with SCZ, an excessive preference for the disadvantageous decks with larger-magnitude less frequent punishments (deck B) may be the main reason of the deficit in affective decision-making, while that in patients with MDD was a significantly decreased ability to choose advantageous decks on the whole but with larger-magnitude less frequent punishments (deck D). As regards patients with BD, the concurrence of more choices of deck B and fewer choices of deck D was the characteristic of the deficit in affective decision-making. Our findings suggest a common affective decision-making impairment in the context of multiple choices in patients with SCZ, MDD, and BD, while the underlying mechanisms of the impairment among these patients may be slightly different.

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‘Cool’ and ‘Hot’ executive functions in suicide attempters with major depressive disorder

Abstract: The disrupted 'cool' EFs patients with MDD are consistent with previous review and meta-analytic studies. On the other hand, the two groups with MDD performed similarly to the healthy controls in the 'hot' EF.

Cited by 40 publications

References 48 publications

Suicidal risk and executive functions in major depressive disorder: a study protocol

Suicidal risk and executive functions in major depressive disorder: a study protocol

Understanding the Complex of Suicide in Depression: from Research to Clinics

A transdiagnostic comparison of affective decision‐making in patients with schizophrenia, major depressive disorder, or bipolar disorder

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