Nangle Jeanne-Marie, Clarke Sarah, Morris Derek W, Schwaiger Siobhan, McGhee Kevin A, Kenny Niamh, Murphy Kevin, Gill Michael, Corvin Aiden, Donohoe Gary
Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Ireland.
Schizophr Res. 2006 Jul;85(1-3):196-200. doi: 10.1016/j.schres.2006.03.035. Epub 2006 May 9.
Although neurocognitive deficits are seen as core to schizophrenia the association between suicidality and neurocognition has received little attention. Our aim was to examine the relationship between neurocognitive variables and suicidal behaviour in patients with schizophrenia and schizoaffective disorder.
Seventy-eight patients with DSM-IV diagnoses of schizophrenia or schizoaffective disorder were categorised as either having attempted suicide or not having attempted suicide based on clinical interview and chart review. Attempters and non-attempters were compared on an extensive neuropsychological battery examining pre-morbid and current general cognitive functioning, episodic memory, and executive functioning.
Suicide attempters tended to out perform non-attempters across all areas of executive functioning, and showed significantly better performances on measures of attention and verbal fluency. After controlling for relevant clinical and demographic variables, the differences between attempters and non-attempters remained significant for measures of attention (F = 4.97, p = 0.03) and verbal fluency (F = 4.28, p = 0.04).
This study adds to existing data that suicide attempters with schizophrenia or schizoaffective disorder may have higher cognitive functioning than non-attempters. In particular, the preservation of higher executive function may influence the ability to initiate and plan suicidal behaviour.
尽管神经认知缺陷被视为精神分裂症的核心特征,但自杀倾向与神经认知之间的关联却很少受到关注。我们的目的是研究精神分裂症和分裂情感性障碍患者的神经认知变量与自杀行为之间的关系。
根据临床访谈和病历审查,将78例诊断为DSM-IV精神分裂症或分裂情感性障碍的患者分为有自杀未遂史和无自杀未遂史两组。对有自杀未遂史和无自杀未遂史的患者进行广泛的神经心理测试,以检查病前和当前的一般认知功能、情景记忆和执行功能。
自杀未遂者在执行功能的各个方面往往比未自杀未遂者表现更好,在注意力和语言流畅性测试中表现也明显更好。在控制了相关的临床和人口统计学变量后,自杀未遂者和未自杀未遂者在注意力测试(F = 4.97,p = 0.03)和语言流畅性测试(F = 4.28,p = 0.04)中的差异仍然显著。
本研究补充了现有数据,即患有精神分裂症或分裂情感性障碍的自杀未遂者可能比未自杀未遂者具有更高的认知功能。特别是,较高执行功能的保留可能会影响发起和计划自杀行为的能力。