Neuropsychological Dysfunction in Depressed Suicide Attempters

Keilp, John G.; Sackeïm, Harold A.; Brodsky, Beth S.; Oquendo, María A.; Malone, Kevin; Mann, J. John

doi:10.1176/appi.ajp.158.5.735

Cited by 327 publications

(303 citation statements)

References 59 publications

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“…It is difficult to say to what extent our results affect the interpretation of earlier findings of association of suicide attempt history with executive impairment in younger individuals (10, 15, 35), not only because of the difference in age, but also because different tests were used. A conservative conclusion would be that the stage of the suicidal process where executive deficits may play a role is yet to be established.…”

Section: Discussionmentioning

confidence: 57%

“…In the first comprehensive study of cognitive performance in attempted suicide, Keilp and colleagues (10) found evidence of executive deficits in high-lethality suicide attempters, specifically on tasks requiring organization and focused effort: the Stroop interference task, the A not B task, verbal fluency task, and the Wisconsin Card Sorting Task (WCST), where suicide attempters failed to maintain cognitive set (10). Subsequent studies have found impairment in specific aspects of executive function, including attentional control (11, 15), response inhibition (14), and verbal fluency (9).…”

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%

See 2 more Smart Citations

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: 57%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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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“…Tests of neuropsychological functioning in depressed suicidal attempters in controls have implicated abnormalities in executive function (Keilp et al 2001), including in older adults (King et al 2000). Rubio and colleagues reported significantly greater hippocampal neurofibrillary pathology in postmortem analysis of elderly suicides and controls (Rubio et al 2001).…”

Section: Neurobiological Factorsmentioning

confidence: 99%

Risk factors for suicide in later life

Conwell

Duberstein

Caine

2002

Biological Psychiatry

620

454

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“…For example, Keilp and colleagues 16 found that depressed, high-lethality suicide attempters performed worse than nonpatients on several neuropsychological measures, and also performed significantly worse than low-lethality attempters on tests of executive functioning. A follow-up study concluded that impaired attention was related to suicidal behavior beyond what could be explained by depression alone.…”

mentioning

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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Neuropsychological Dysfunction in Depressed Suicide Attempters

Cited by 327 publications

References 59 publications

Impaired Executive Function in Contemplated and Attempted Suicide in Late Life

Impaired Executive Function in Contemplated and Attempted Suicide in Late Life

Risk factors for suicide in later life

Differential Effects of Executive Functioning on Suicide Attempts

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