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

Psychological Medicine - Tập 44 Số 14 - Trang 2965-2974 - 2014
John G. Keilp1,2, S. R. Beers3,4, Ainsley K. Burke1,2, Nadine Melhem3,4, María A. Oquendo1,2, David A. Brent3,4, J. John Mann1,2
1Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
2Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
3Department of Psychiatry, University of Pittsburgh School of Medicine; Pittsburgh, PA USA
4Western Psychiatric Institute and Clinic, Pittsburgh PA, USA

Tóm tắt

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.

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Tài liệu tham khảo

10.1111/j.1600-0447.2005.00585.x

First, 1996, Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II)

10.1016/j.jpsychires.2010.03.006

10.1111/j.2044-8260.1967.tb00530.x

10.1176/appi.ajp.162.2.304

Spreen, 2006, A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary

10.1016/j.jad.2008.03.019

10.1017/S0033291712001419

10.1136/jnnp.23.1.56

10.3109/15622975.2011.556200

10.1016/j.psychres.2007.08.020

Spitzer, 1990, Instruction Manual for the Structured Clinical Interview for the DSM-IV (SCID-P)

10.1016/j.jpsychires.2011.10.001

10.1016/j.jad.2006.12.006

Bishop, 2004, Mindfulness: a proposed operational definition, Clinical Psychology: Science and Practice, 11, 230

10.1136/bmj.c2506

10.1001/archpsyc.59.9.801

Barratt, 1985, Advances in Personality Assessment, 5, 113

10.1037/0022-006X.47.2.343

10.1037/h0046900

10.1001/archpsyc.1961.01710120031004

Baer, 2003, Mindfulness training as a clinical intervention: a conceptual and empirical review, Clinical Psychology: Science and Practice, 10, 125

Mann, 1999, Toward a clinical model of suicidal behavior in psychiatric patients, American Journal of Psychiatry, 156, 181, 10.1176/ajp.156.2.181

10.1037/h0037562

Oquendo, 2003, Standardized Evaluation in Clinical Practice: Review of Psychiatry, 22, 103

Barratt, 1994, Violence and Mental Disorder: Developments in Risk Assessment, 61

Beck, 1975, Classification of suicidal behaviors: I. Quantifying intent and medical lethality, American Journal of Psychiatry, 132, 285, 10.1176/ajp.132.3.285

10.1016/j.biopsych.2010.12.025

Dunn, 1997, Peabody Picture Vocabulary Test

10.1176/appi.ajp.2007.06091522

10.1016/j.jaac.2012.01.002

10.1017/S0033291712001043

10.1037/a0021646

Linehan, 2008, Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual, 365

10.1176/appi.ajp.2009.09030407

10.1176/appi.ajp.158.5.735

10.1016/j.comppsych.2007.07.004

10.1136/bmj.38310.473565.8F

10.1007/s00406-008-0811-1

10.1016/j.psychres.2005.03.006

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Psychological Medicine

Tập 44 Số 14

2965-2974

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