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Neuropsychological function and suicidal behavior: attention control, memory and executive dysfunction in suicide attempt

Published online by Cambridge University Press:  10 July 2012

J. G. Keilp ,
M. Gorlyn ,
M. Russell ,
M. A. Oquendo ,
A. K. Burke ,
J. Harkavy-Friedman  and
J. J. Mann
J. G. Keilp*
Affiliation:
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, NY, USA Department of Psychiatry, Columbia University College of Physicians and Surgeons, NY, USA
M. Gorlyn
Affiliation:
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, NY, USA Department of Psychiatry, Columbia University College of Physicians and Surgeons, NY, USA
M. Russell
Affiliation:
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, NY, USA Department of Psychiatry, Columbia University College of Physicians and Surgeons, NY, USA
M. A. Oquendo
Affiliation:
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, NY, USA Department of Psychiatry, Columbia University College of Physicians and Surgeons, NY, USA
A. K. Burke
Affiliation:
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, NY, USA Department of Psychiatry, Columbia University College of Physicians and Surgeons, NY, USA
J. Harkavy-Friedman
Affiliation:
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, NY, USA Department of Psychiatry, Columbia University College of Physicians and Surgeons, NY, USA
J. J. Mann
Affiliation:
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, NY, USA Department of Psychiatry, Columbia University College of Physicians and Surgeons, NY, USA
*
*Address for correspondence: Dr J. G. Keilp, Box 42, New York State Psychiatric Institute (NYSPI), 1051 Riverside Drive, New York, NY 10032, USA. (Email: jgk13@columbia.edu)
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Abstract

Background

Executive dysfunction, distinct from other cognitive deficits in depression, has been associated with suicidal behavior. However, this dysfunction is not found consistently across samples.

Method

Medication-free subjects with DSM-IV major depressive episode (major depressive disorder and bipolar type I disorder) and a past history of suicidal behavior (n = 72) were compared to medication-free depressed subjects with no history of suicidal behavior (n = 80) and healthy volunteers (n = 56) on a battery of tests assessing neuropsychological functions typically affected by depression (motor and psychomotor speed, attention, memory) and executive functions reportedly impaired in suicide attempters (abstract/contingent learning, working memory, language fluency, impulse control).

Results

All of the depressed subjects performed worse than healthy volunteers on motor, psychomotor and language fluency tasks. Past suicide attempters, in turn, performed worse than depressed non-attempters on attention and memory/working memory tasks [a computerized Stroop task, the Buschke Selective Reminding Task (SRT), the Benton Visual Retention Test (VRT) and an N-back task] but not on other executive function measures, including a task associated with ventral prefrontal function (Object Alternation). Deficits were not accounted for by current suicidal ideation or the lethality of past attempts. A small subsample of those using a violent method in their most lethal attempt showed a pattern of poor executive performance.

Conclusions

Deficits in specific components of attention control, memory and working memory were associated with suicidal behavior in a sample where non-violent attempt predominated. Broader executive dysfunction in depression may be associated with specific forms of suicidal behavior, rather than suicidal behavior per se.

Keywords

Bipolar disordercognitiondepressionneuropsychologysuicidal behavior
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 3 , March 2013 , pp. 539 - 551
Copyright
Copyright © Cambridge University Press 2012

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