Prefrontal cortex dysfunction in patients with suicidal behavior

Raust, Aurélie; Slama, Frédéric; Mathieu, Flavie; Roy, Isabelle; Chenu, Alain; Koncke, Diego; Fouques, Damien; Jollant, Fabrice; Jouvent, Éric; Courtet, Philippe; Leboyer, Marion; Bellivier, Frank

doi:10.1017/s0033291706009111

Cited by 123 publications

(57 citation statements)

References 47 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%

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%

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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“…41 Therefore, OFC and VPC dysfunction in alexithymics may cause a perturbation of HPA functioning, leading to a dyslipidemia that may be associated with increased suicidal ideation. 42 However, the relationships between alexithymia, serum lipid levels, and suicidal ideation remain unclear.…”

Section: Discussionmentioning

confidence: 99%

Alexithymia, suicidal ideation, and serum lipid levels among drug-naïve outpatients with obsessive-compulsive disorder

Berardis

Serroni

Marini

et al. 2014

Rev. Bras. Psiquiatr.

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Objective: As obsessive-compulsive disorder (OCD) is a relatively common psychiatric disorder with a significant suicide risk, the individuation of potential biomarkers of suicidality, such as cholesterol levels, may enable recognition of at-risk subjects. Therefore, the aims of this study were to: 1) evaluate potential differences in clinical and laboratory parameters between patients with and without alexithymia and compare them with healthy controls; and 2) investigate which clinical and laboratory variables were associated with suicidal ideation. Methods: 79 drug-naïve adult outpatients with a DSM-IV diagnosis of OCD were recruited. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20), suicidal ideation was assessed with the Scale for Suicide Ideation, and depressive symptoms were evaluated with the Montgomery-Å sberg Depression Rating Scale (MADRS). Serum lipid levels of 40 healthy controls were also evaluated. Results: Alexithymic patients had altered serum lipid levels in comparison with non-alexithymics and healthy controls. Using a linear regression model, the presence of symmetry/ordering obsessions and compulsions, lower HDL-C levels, and difficulty in identifying feelings dimension of the TAS-20 were associated with higher suicidal ideation. Conclusions: Alexithymic individuals with OCD may exhibit dysregulation of the cholesterol balance, which in turn may be linked to suicidal ideation. Further prospective studies are required to elucidate this potential association.

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“…(Kessler et al, 1999;Coryell and Young, 2005). Several studies have demonstrated the relationship between impulsivity and suicide (Baca-Garcia et al, 2005;Raust et al, 2006). Particularly a recent report found the relationship between impulsive action and suicide attempts in bipolar disorder patients (Swann et al, 2005).…”

Section: Introductionmentioning

confidence: 97%