McGill University, Department of Psychiatry and Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montreal, Quebec.
Can J Psychiatry. 2012 Apr;57(4):254-62. doi: 10.1177/070674371205700409.
Suicide has been related to affective disorders. We hypothesized that suicide could be associated with cognitive inhibition deficit. Our study aimed to systematically review all published articles that examined the relation between cognitive inhibition deficit and suicidal behaviours (that is, suicide attempt or suicidal ideation) in patients with affective disorders.
We performed an English and French MEDLINE and EMBASE search, ranging from 1970 to 2010, indexed under the MeSH terms of suicide, neuropsychology, neuropsychological tests, and executive function, combined with the following title and abstract terms: neuropsychological functions, executive functioning, and executive performance.
Among the 164 selected studies, 9 observational studies met the selection criteria and were included in the final analysis. The number of participants ranged from 57 to 244 (28% to 66%, respectively, were men). Executive dysfunction was more frequently found among patients with suicidal behaviours. In particular, higher cognitive inhibition deficit was observed in depressed subjects with suicide behaviours, compared with depressed subjects without any suicidal behaviour. The results of the meta-analysis showed a higher impairment in inhibition score, according to the number of perseverations in the Wisconsin Card Sorting Test (Cohen d = 0.68) than in inhibition according to the time needed to perform the Trail-Making Test part B (d = 0.01) among patients with suicidal behaviour, compared with patients with no suicidal behaviour.
This systematic review and meta-analysis showed a positive association between cognitive inhibition deficit and suicide attempts in patients with affective disorders. Future research should examine whether cognitive inhibition deficit precedes the suicidal behaviour.
自杀与情感障碍有关。我们假设自杀可能与认知抑制缺陷有关。我们的研究旨在系统地回顾所有已发表的文章，这些文章检查了认知抑制缺陷与情感障碍患者的自杀行为（即自杀未遂或自杀意念）之间的关系。
我们进行了英语和法语的 MEDLINE 和 EMBASE 搜索，范围从 1970 年到 2010 年，使用自杀、神经心理学、神经心理测验和执行功能的 MeSH 术语进行索引，并结合以下标题和摘要术语：神经心理学功能、执行功能和执行表现。
在 164 项选定的研究中，有 9 项观察性研究符合选择标准，并纳入最终分析。参与者人数从 57 人到 244 人不等（分别为 28%到 66%为男性）。自杀行为患者中更常发现执行功能障碍。特别是，与没有任何自杀行为的抑郁患者相比，有自杀行为的抑郁患者的认知抑制缺陷更高。荟萃分析的结果表明，在威斯康星卡片分类测试中的持续错误次数（Cohen d = 0.68），而不是在执行 Trail-Making Test 部分 B 所需的时间（d = 0.01）方面，抑制得分的损伤更高在有自杀行为的患者中，与没有自杀行为的患者相比。
本系统评价和荟萃分析显示，认知抑制缺陷与情感障碍患者的自杀未遂之间存在正相关。未来的研究应该检查认知抑制缺陷是否先于自杀行为。
